择期冠脉支架治疗不稳定型心绞痛患者术前早期使用氯吡格雷的疗效评价

目的评价早期使用氯吡格雷对拟接受冠脉支架术的不稳定型心绞痛(UAP)患者近期预后的影响。方法拟行择期冠脉支架治疗的UAP患者,随机分为早期用药组和对照组,早期用药组272名患者于冠脉支架术前3d开始服用氯吡格雷治疗(首次给负荷量300mg,后以75mg/d维持);对照组265名患者,于冠脉支架术前1d开始用药(首次服用氯吡格雷300mg,术后75mg/d维持)。比较两组患者术后30d内心血管死亡、支架血栓、心肌梗死和靶血管血运重建等心血管不良事件(MACE)的发生率。结果两组患者在临床病情、冠脉病变及冠脉支架治疗方面无明显差异。30d内早期用药组支架血栓、靶血管血运重建及联合心血管事件的发生率显著低于对照组(P<0.05)。结论冠脉支架术前早期使用氯吡格雷能够明显减少UAP患者MACE的发生率,显著改善患者冠脉支架术后的近期预后。

Early Clopidogrel Treatment before Coronary Stent in Patients with UAP: A Study of Effect

Objective To evaluate the short-term prognosis effect of early clopidogrel treatment before coronary stent in patients with UAP.Methods Patients with UAP,who would be given coronary stent,were randomly divided into two groups:Group A,an early treatment group(n=272)and Group B,a control group(n=265).Group A were given a treatment of clopidogrel three days before coronary stent(300mg loading dose for the first time,then 75mg daily);Group B were given clopidogrel one day before the procedure(300mg loading dose for the first time,then 75mg per day after the procedure).We observed the incidence of major adverse coronary events(MACE),such as cardiovascular death,support thrombus,target vessel revascularization etc.Results No significant difference was found in clinical state of illness,coronary pathologic changes and coronary stent ;By contrast,Group A was remarkably lower in incidence of support thrombus,target vessel revascularization and combined cardiovascular events within 30 days than Group B(P<0.05).Conclusion Early clopidogrel treatment before coronary stent can reduce remarkably the incidence of MACE in patients with UAP,and improve the short-term prognosis effect after coronary stent.