Application of dabigatran etexilate in anticoagulation therapy for patients with nonvalvular atrial fibrillation after PCI
10.3969/j.issn.1009-0126.2025.04.017
- VernacularTitle:达比加群酯在非瓣膜性心房颤动经皮冠状动脉介入治疗术后抗凝治疗中的应用
- Author:
Qian ZHANG
1
;
Wenbin ZHANG
;
Jingjun FAN
;
Juan YANG
Author Information
1. 550004 贵阳,贵州省第二人民医院药剂科临床药学室
- Publication Type:Journal Article
- Keywords:
percutaneous coronary intervention;
atrial fibrillation;
dabigatran;
anticoagulants
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(4):473-477
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application efficacy of dabigatran etexilate in anticoagulation for patients with nonvalvular atrial fibrillation after percutaneous coronary intervention(PCI).Methods A total of 103 AF patients undergoing PCI in our hospital from February 2021 to Janu-ary 2023 were recruited,and based on different anticoagulation regimens,they were divided into routine group(warfarin,52 cases)and dabigatran etexilate group(dabigatran etexilate,51 cases).The coagulation function indicators[prothrombin time(PT),active partial thromboplasting time(APTT),thrombin time(TT),fibrinogen(FIB)].cardiac function[left ventricular ejection frac-tion(LVEF),cardiac index,cardiac output],vascular endothelial function[nitric oxide(NO),en-dothelin-1(ET-1)],serum tissue-type plasminogen activator(t-PA),plasminogen activator inhib-itor-1(PAI-1)and Rac-related protein(Rac1)levels before and after treatment,and the incidences of adverse cardiovascular events(acute myocardial infarction,sudden cardiac death,ischemic stroke,pulmonary embolism,lower extremity deep venous thrombosis)and bleeding events in 1 year after surgery were compared between the two groups.Results After 2 months of treatment,LVEF,cardiac index,cardiac output,PT,APTT,TT and NO level were significantly increased while the FIB,ET-1,t-PA,PAI-1 and Rac1 levels were significantly decreased in the two groups(P＜0.05).At the moment,the dabigatran etexilate group had obviously higher LVEF,cardiac in-dex,cardiac output,longer PT,APTT and TT,and elevated NO level,while remarkably lower FIB,ET-1,t-PA,PAI-1 and Rac1 levels than the routine group(P＜0.05,P＜0.01).The incidence of bleeding events was significantly lower in the dabigatran etexilate group than the routine group(5.9％vs 19.2％,P＜0.05).Conclusion Dabigatran etexilate can effectively improve the coagula-tion function of AF patients after PCI,has a certain protective effect on vascular endothelial func-tion and cardiac function,and can reduce the risk of bleeding,which provides a reference for the selection of clinical anticoagulation regimen.
