1.Comparison of Preventive Effects and Safety of Aspirin and Clopidogrel Respectively Used for Vascular Re-stenosis after Coronary Intimal Stripping with Coronary Artery Bypass Grafting
Lianhe WU ; Yanchi WANG ; Shen ZHANG ; Luyu MENG ; Zhengsheng ZHANG ; Huaixue MI
China Pharmacy 2017;28(6):762-765
OBJECTIVE:To compare the preventive effects and safety of aspirin and clopodogrel respectively used for vascular restenosis after coronary intimal striping with coronary artery bypass grafting. METHODS:110 patients with coronary atherosclerot-ic heart disease were divided into aspirin group (55 cases) and clopodogrel group (55 cases). All patients intravenously mi-cro-pumped Nitroglycerin injection 10 mg+5% Glucose injection totally 20 mL for maintaining 48-72 h after coronary intimal strip-ing with coronary artery bypass grafting,intravenously pumped Dopamine hydrochloride injection 1-5 μg/kg if necessary. Unplug the endotracheal tube after surgery,patients received Cefuroxime sodium for injection 1.5 g adding into Sterile water for injection 50 mL,intravenous injection,3 times a day,for 2-3 d. Meanwhile,patients were orally given Rosuvastatin calcium tablet 10 mg 30 min after daily dinner,8-week was a course,for 3 courses. Based on it,aspirin group received Aspirin enteric-coated tablet with initial dose of 300 mg,once a day,orally taking 100 mg from the second day,once a day,for 6 months;clopodogrel group received Clopidogrel hydrogen sulfate tablet with initial dose of 300 mg,once a day,orally taking 75 mg from the second day, once a day,for 6 months. Graft patency rate,and platelet aggregation rate,platelet aggregation compliance rate,fibrinogen(Fg), D-dimer (D-D),platelet count (PLT),tissue-type plasminogen activator (t-PA) before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the graft patency rate and inci-dence of adverse reactions in 2 groups (P>0.05). Before treatment,there were no significant differences in platelet aggregation rate,platelet aggregation compliance rate,Fg,D-D,PLT and t-PA in 2 groups (P>0.05). After treatment,platelet aggregation rate,Fg and D-D level in 2 groups were significantly lower than before,platelet aggregation compliance rate,PLT and t-PA level were significantly higher than before,with statistical significance(P<0.05),while there were no significant differences between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treatment,both aspirin and clopidogrel used for coronary intimal strip-ing with coronary artery bypass grafting can inhibit platelet aggregation,reduce thrombosis,maintain vascular patency and prevent vascular restenosis,with good safety.