经皮冠状动脉介入术后二联和三联抗凝治疗冠心病合并心房颤动的临床效果分析

Strategy of Antiplatelet Anticoagulant Therapy for Patients with Coronary Heart Disease Complicated with Atrial Fibrillation after Percutaneous Coronary Intervention

目的 探讨接受经皮冠状动脉介入治疗的冠状动脉粥样硬化性心脏病合并心房颤动患者的术后抗血小板抗凝治疗策略.方法 将某院2016年6月30日-2018年6月30日收治的50例接受经皮冠状动脉介入治疗的冠心病合并心房颤动患者随机分为治疗组和对照组,经皮冠状动脉介入术后予以治疗组华法林+阿司匹林+氯吡格雷抗血小板抗凝治疗,予以对照组阿司匹林+氯吡格雷抗血小板抗凝治疗,用药2个月后进行疗效比较.结果 治疗组PCI术后心血管不良事件发生率12%低于对照组36%,出血发生率24%高于对照组4.0%.结论 华法林、阿司匹林、氯吡格雷三联方案用于冠心病合并心房颤动患者PCI术后抗血小板抗凝治疗的效果更显著,但出血风险也相对较大.

Objective To investigate the antiplatelet anticoagulant therapy in patients with coronary heart disease and atrial fibrillation undergoing percutaneous coronary intervention.Methods 50 patients with coronary heart disease and atrial fibrillation who underwent PCI were randomly divided into treatment group and control group.The postoperative treatment group received warfarin+aspirin+clopidogrel antiplatelet anticoagulant therapy,and the control group received aspirin+clopidogrel antiplatelet anticoagulant therapy.The efficacy after 2 months of treatment was compared.Results The incidence of cardiovascular adverse events after PCI in the treatment group was 12%lower than that in the control group(36%),and the bleeding rate was 24%higher than the control group(4%).Conclusions Warfarin,aspirin and clopidogrel were more effective in antiplatelet anticoagulant therapy after PCI in patients with coronary heart disease and atrial fibrillation,but the risk of bleeding was relatively large.