华法林预防冠脉支架术后78例血栓形成的疗效

Clinical effects of warfarin on prevention of stent thrombosis after percutaneous coronary intervention

目的:观察华法林预防冠脉支架术后血栓形成的有效性和安全性。方法:冠脉支架术后患者78例分为2组,金属裸支架组和药物涂层支架组。在常规治疗的基础上,调整华法林剂量,使INR值保持在2.0左右,观察早期和晚期支架术后患者心绞痛、心肌梗死等临床急性事件的发生及出血并发症。结果:使用华法林后,两组早期未见临床急性事件出现,也未见出血并发症,晚期出现心绞痛两组分别为3例与1例,未发生心肌梗死事件和出血。对4例心绞痛患者再次行冠脉造影显示,置入支架处未见血栓及再狭窄,而是其他血管和血管段出现了冠脉狭窄。结论:华法林可防止冠脉支架术后血管形成的急性事件,无论是金属裸支架或药物支架,只要剂量适当,这种作用是安全有效的。

AIM： To observe the clinical safety and effectiveness of warfarin on the prevention of stent thrombosis after percutaneous coronary intervention （PCI）. METHODS： Of the 78 patients who were treated with stents, 48 patients with bare-metal stents were enrolled in group A and 30 patients with drugeluting stents in group B. The clinical manifestations of the two groups were similar. All patients received routine treatment and adjusted dose of warfarin （ international normalized ratio 1.5 - 2.0）. We observed and compared the effect of warfarin on acute cardiac events and complications during and after the first month. RESULTS： During the first month, no occurrences of angina and acute myocardial infarction were seen in all the patients, and there were no hemorrhagic complications. After the first month, one case of angina was observed in group A and three cases in group B, but no acute myocardial infarction was seen in either group A or group B. Stenosis was observed in other coronary arteries, but no thrombosis and in-stent restenosis were found at stents. CONCLUSION： Warfarin may prevent acute cardiac event after PCI. With proper dosage, this medication is safe and effective for both bare-metal stents and drugeluting stents.