不同双联抗血小板治疗时间对FIREBIRD支架置入患者的影响

背景：研究表明，支架内血栓直接影响了药物洗脱支架置入后近远期疗效。 目的：观察分析不同时间的双联抗血小板治疗对Firebird支架置入后冠心病患者心血管不良事件发生率的影响。 方法：选择置入Firebird国产雷帕霉素洗脱支架的患者1 107例，分为阿司匹林+硫酸氯吡格雷3月以内、3~6个月、< 6~12个月组，记录患者心血管不良事件发生率，药物不良反应的发生率及材料宿主反应。 结果与结论：实际随访例数为1 059例(共置入支架1 431枚)，随访时间由7~59个月不等，临床随访率为95.7%。3月以内、3~6个月、< 6~12个月组患者主要心血管不良事件(MACE)发生率分别为8.9%，7.7%，4.4%，差异有显著性意义。3组患者心力衰竭、急性心肌梗死、再次血运重建和主要心脏事件发生率差异均有显著性意义(P < 0.05或< 0.01)，< 6~12个月组发生率最低。各组患者均未发生材料宿主反应。提示，国产Firebird雷帕霉素洗脱支架置入后延长口服氯吡格雷时间至12个月甚至更长患者心血管事件的发生率降低，且不增加药物不良事件的发生率。

Effects of different dual antiplatelet therapies periods on patients with coronary heart disease treated by firebird stents

BACKGROUND: The stent thrombosis has a direct impact on the immediate and long-term outcomes following drug eluting stents implantation. OBJECTIVE: To evaluate the effects of different dual antiplatelet therapies periods on the incidence of cardiovascular adverse events in patients with coronary heart disease treated by Firebird stents METHODS: A total of 1 107 consecutive patients with coronary artery disease who received Firebird stent implantation were selected. These patients were divided into three groups based on the time of applying asprin and clopidogrel. Major adverse cardiac events (MACE), drug adverse effect and host response to materials were recorded. RESULTS AND CONCLUSION: 1 059 cases with 1 431 stents were followed up for 7-59 months, and clinical follow-up rate was 95.7%. Rate of MACE occurrence in the group of applying asprin and clopidogrel over 6 months (4.4%) were much lower than other groups (8.9% and 7.7%), there was significant difference among these groups (P < 0.05). Rate of non-fatal myocardial infarction, heart fail, target vessel revascularization and bleeding occurrence in the group of applying asprin and clopidogrel over 6 months were much lower than other groups, there was significant difference among these groups (P < 0.05 or < 0.01). There was no host response to materials in the three groups. The clinical follow-ups showed that the group of applying asprin and clopidogrel until 12 months has a definite clinical efficacy in the patients with coronary artery disease who received Firebird stent implantation, which could reduce the occurrence of MACEs.