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|本期目录/Table of Contents|

替格瑞洛在补救PCI患者中的疗效及安全性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第3期
页码:
312-315
栏目:
临床研究
出版日期:
2016-01-05

文章信息/Info

Title:
Efficacy and safety of ticagrelor in patients with ST elevation myocardial infarction undergoing rescue PCI for failed thrombolysis
作者:
李康博; 刘晓坤; 张 琦; 韩全乐
（华北理工大学附属唐山工人医院心血管科，河北 唐山 063000 ）
Author(s):
LI Kang-bo;  LIU Xiao-kun;  ZHANG Qi;  HAN Quan-le
(Department of Cardiology, Tangshan Worker’s Hospital, North China University of Science and Technology, Tangshan 063000, Hebei, China)
关键词:
经皮冠状动脉介入治疗; 替格瑞洛： 氯吡格雷
Keywords:
rescue PCI;  ticagrelor;  clopidogrel
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 观察替格瑞洛在溶栓失败后补救性经皮冠状动脉介入治疗（PCI）患者中的疗效及安全性。方法 入选2013~2014年因急性ST段抬高型心肌梗死（STEMI）的溶栓失败后12 h内于我院行补救PCI的患者246例。随机将符合条件的患者分为替格瑞洛组（n=121）和氯吡格雷组（n=125），替格瑞洛组术前给予替格瑞洛180 mg，术后90 mg bid联合阿司匹林100 mg qd；氯吡格雷组术前给予氯吡格雷300 mg，术后75 mg qd联合阿司匹林100 mg qd。采用TIMI血流分级（TFG）、校正的TIMI记帧（CTFC）和TIMI心肌灌注分级（TMPG）评价比较两组术后心肌灌注水平。随访12月比较两组患者的主要不良心脑血管事件（MACCE）的发生率和出血事件及其它不良事件的发生率。结果 两组心肌灌注水平差异无统计学意义。替格瑞洛组与氯吡格雷组相比MACCE复合终点累计发生率降低，差异具有统计学意义（6.6% vs. 15.2% HR=0.395,95%CI:0.166-0.940,P<0.05）。两组总体主要出血、主要致命/危及生命的出血事件发生率差异无统计学意义。结论 替格瑞洛在溶栓失败后补救PCI患者中同样安全有效。
Abstract:
AIM To evaluate the efficacy and safety of ticagrelor in patients with ST elevation myocardial infarction (STEMI) undergoing rescue PCI for failed thrombolysis. METHODSTwo hundred and forty-six consecutive STEMI patients undergoing rescue PCI for failed thrombolysis were randomly assigned to ticagrelor group (180 mg loading dose followed by 90 mg bid) or to clopidogrel group (300 mg loading dose followed by 75 mg qd) for 12 months. All patients were given aspirin (100 mg qd). Myocardial perfusion was assessed by TFG, CTFC and TMPG. Major adverse cardiovascular and cerebrovascular events (cardiovascular death, nonfatal myocardial infarction, stroke, target vessel revascularization and stent thrombosis formation) and clinical complications were evaluated. RESULTSThe primary composite endpoint occurred in fewer patients in ticagrelor group than in clopidogrel group (6.6% vs. 15.2% HR=0.395, 95%CI: 0.166-0.940, P<0.05). There was no significant difference between clopidogrel and ticagrelor groups in the rates of total major bleeding or severe bleeding. CONCLUSIONTicagrelor appears to be a safer and more efficacious option than clopidogrel for STEMI patients undergoing rescue PCI for failed thrombolysis.

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备注/Memo

备注/Memo:
收稿日期：2015-06-17.
基金项目：唐山市科技计划项目资助（13130258a）
通讯作者：刘晓坤,主任医师，主要从事急性冠脉综合征的血运重建研究 Email：lxiaokun@sohu.com
作者简介：李康博,医师，硕士 Email：leanatncmc@163.com
更新日期/Last Update: 2016-01-07