替格瑞洛与氯吡格雷对冠状动脉三支病变介入治疗患者住院期间及长期临床结果比较

目的 分析比较替格瑞洛与氯吡格雷对冠状动脉三支病变介入治疗后患者的疗效及安全性。方法 选择冠状动脉三支病变并接受经皮冠状动脉介入 (PCI)治疗的患者119例，随机分为2组，术后给予氯吡格雷组患者氯吡格雷加阿司匹林的双联抗血小板治疗12个月，给予替格瑞洛组患者替格瑞洛加阿司匹林的双抗治疗12个月，在术后第1、3、6、9、12个月分别对患者进行随访。结果 12个月2组患者的全因死亡率分别为10.7%和8.9%，组间比较差异无统计学意义（χ2 = 0.103，P＞0.05）。12个月内替格瑞洛组的主要心血管不良事件（MACE）事件发生率为26.8%，氯吡格雷组为46.4%，组间比较差异具有统计学意义（χ2 = 4.819，P＜0.05）。随访期间氯吡格雷组和替格瑞洛组发生TIMI小出血或TIMI轻微出血的例数分别为7例和16例，组间比较差异具有统计学意义（χ2 = 4.432，P＜0.05）。氯吡格雷组与替格瑞洛组发生TIMI主要出血的患者分别为2例和3例，组间比较差异无统计学意义（P＞0.05）。结论 替格瑞洛相较氯吡格雷可有效减少冠心病三支病变介入治疗后患者MACE事件的发生率。替格瑞洛相较氯吡格雷使患者TIMI小出血和轻微出血的风险增加，但不增加TIMI主要出血的风险。

Comparison of long-term and in-hospital clinical outcomes between ticagrelor and clopidogrel in patients with three-vessel coronary artery disease after interventional therapy

Objective Analysis and comparison of the efficacy and safety of ticagrelor and clopidogrel in patients with three-vessel coronary artery disease after interventional therapy. Methods A total of 119 patients with three-vessel coronary heart disease who underwent percutaneous coronary intervention in our hospital were randomly divided into two groups: one group of patients received 12 months of double antiplatelet therapy with clopidogrel and aspirin, and the other group received 12 months of double-antibody treatment with ticagrelor and aspirin. The patients were followed up at 1, 3, 6, 9, and 12 months after surgery. Results The all-cause mortality rate of the two groups was 10.7% and 8.9% within 12 months, and there was no significant difference between the two groups(χ2=0.103, P>0.05). The incidence of Major Adverse Cardiovascular Events (MACE) was 26.8% in the ticagrelor group and 46.4% in the clopidogrel group within 12 months. The difference between the groups was statistically significant (χ2=4.819, P<0.05). During the follow-up period, the number of TIMI minor hemorrhages or TIMI minor hemorrhage in the clopidogrel group and the ticagrelor group were 7 and 16 respectively. The difference between the two groups was statistically significant (χ2=4.432, P<0.05). There were 2 patients and 3 patients with major bleeding in the clopidogrel group and the ticagrelor group. There was no significant difference between the two groups(P>0.05). Conclusion Compared with clopidogrel, ticagrelor can effectively reduce the incidence of MACE events in patients with coronary artery disease after interventional therapy. Compared with clopidogrel, ticagrelor increased the risk of TIMI minor bleeding, but did not increase the risk of major TIMI bleeding.