替格瑞洛在老年STEMI患者急诊PCI中的疗效与安全性分析

Efficacy and safety of ticagrelor combined with primary PCI in elderly patients with ST-elevated acute myocardial infarction

目的观察替格瑞洛在老年急性ST段抬高型心肌梗死(ST-segment elevated myocardial infarction,STEMI)患者急诊经皮冠状动脉介入治疗术(percutaneous coronary artery intervention,PCI)中的疗效和安全性。方法 2013年4月至2014年10月行急诊PCI术的60岁以上STEMI患者113例,采用数字表法随机分为负荷量替格瑞洛组(57例)和氯吡格雷组(56例),分别给予300 mg阿司匹林和180 mg替格瑞洛嚼服及300 mg阿司匹林和600 mg氯吡格雷嚼服。观察并比较2组患者急诊PCI术后无复流情况及术后1个月内主要心脏不良事件(major adverse cardiovascular events,MACE)发生率及出血、呼吸困难及恶性心律失常的发生率。结果替格瑞洛组无复流发生率以及术后1个月MACE的发生率均低于氯吡格雷组(P<0.05);而2组主要出血、恶性心律失常的发生率差异无统计学意义(P>0.05)。结论在老年STEMI患者的急诊PCI治疗中,应用替格瑞洛抗栓疗效显著,且安全性较好。

Objective To observe the efficacy and safety of ticagrelor combined with primary percutaneous coronary intervention（ PCI） in elderly patients with ST-segment elevated myocardial infarction（ STEMI）. Methods Totally 113 elderly patients with STEMI were divided into two groups. Patients in ticagrelor group were given aspirin 300 mg/ticagrelor 180 mg; and those in clopidogrel group were given aspirin 300 mg/clopidogrel 600 mg before primary PCI. No-reflow events and thrombolysis in myocardial infarction（ TIMI）blood flow in coronary artery after primary PCI,major adverse cardiovascular events（ MACE） within one month,bleeding events,dyspnea and malignant ventricular arrhythmia were detected. Results The incidence of no-reflow and MACE of ticagrelor group was significantly lower than that in clopidogrel group（ P 0. 05）. There was no significant difference in bleeding events and malignant ventricular arrhythmia between the two groups. Conclusion Ticagrelor combined with primary PCI in treatment of the elderly patients with STEMI were effective and safe.