冠心病介入术后女性患者不同的MAADP对抗栓治疗有效性和安全性的影响

Efficacy and Safety of Different MA_(ADP) in Antithrombotic Therapy for Female Patients with Coronary Artery Disease after Interventional Therapy

目的对于行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)、服用双联抗血小板药物的女性冠心病患者,评估不同的二磷酸腺苷诱导的血小板纤维蛋白凝块强度(adenosine diphosphate-induced platelet-fibrin clot strength,MAADP)对抗栓治疗有效性和安全性的影响。方法本研究纳入2013年1月至12月于阜外医院行PCI且有术后12~72 h血栓弹力图检测结果的女性冠心病患者1070例,分为MAADP<31mm、31mm≤MAADP≤47mm、MAADP>47mm三组。缺血性主要终点为死亡,缺血性次要终点为心肌梗死,出血终点为BARC3、5型。结果通过2年的随访,三组的缺血性主要终点、次要终点及出血终点均差异无显著性(P>0.05),Cox分析显示,MAADP并非是缺血及出血事件的独立预测因素。结论对于行PCI治疗的女性冠心病患者,不同的MAADP对抗栓疗效和安全性均差异无显著性。

Objective To evaluate the effect of different adenosine diphosphate induced platelet fibrin clot strength(MAADP)on the efficacy and safety of antithrombotic therapy in female patients with coronary heart disease undergoing percutaneous coronary intervention(PCI)and taking dual antiplatelet drugs.Methods A total of 1070 female patients with coronary heart disease who underwent PCI in Fuwai Hospital from January to December 2013 and had the results of thromboelastography 12-72 h after PCI were included in this study.They were divided into three groups:MAADP<31 mm,31 mm≤MAADP≤47 mm,MAADP>47 mm.The primary end point of ischemia was death,the secondary end point of ischemia was myocardial infarction,and the end point of bleeding was BARC type 3 and 5.Results There was no significant difference in the primary,secondary and bleeding endpoints among the three groups(P>0.05)after 2 years of follow-up.COX regression model analysis shows that MAADP is not an independent predictor of ischemic and hemorrhagic events.Conclusion For female patients with coronary heart disease undergoing PCI,there was no significant difference in the efficacy and safety of different MAADP.