摘要
目的探讨低剂量替格瑞洛治疗非左主干急性心肌梗死患者的有效性及安全性。方法选取2019年1月至2020年1月就诊于宁波市第一医院心脏中心的226例非左主干急性心肌梗死患者为研究对象,采用随机数字表法分为两组:低剂量组、标准剂量组,每组113例。两组患者予以替格瑞洛180 mg负荷剂量后,分别给予不同的维持剂量(60、90 mg)持续12个月,同时联合应用Ⅰ类推荐药物。比较两组患者治疗1周后P2Y12反应单位(PRU)以及1年内有效性及安全性终点事件发生率。结果低剂量组PRU为(85.23±21.15)U,明显高于标准剂量组的(54.96±15.22)U(P<0.05)。低剂量组患者安全性终点事件合计发生率、小出血发生率分别为19.5%、11.5%,低于标准剂量组的34.5%、24.8%(均P<0.05),HR值及95%CI分别为0.564(0.351~0.905)、0.464(0.254~0.849);两组患者大出血事件及有效性终点事件比较,差异均无统计学意义(均P>0.05)。结论低剂量替格瑞洛治疗非左主干急性心肌梗死患者有效,且能降低小出血事件发生率。
Objective To evaluate the efficacy and safety of low dose ticagrelor in patients with non-left main acute myocardial infarction.Methods A total of 226 AMI patients with non-left main lesion in Ningbo First Hospital from January 2019 to January 2020 were enrolled and equally assigned to two groups randomly:low-dose and standard-dose group.After given a loading dose of 180 mg ticagrelor,the two groups were given different maintenance doses of ticagrelor(60 mg and 90 mg)for 12 months,and combined with other classⅠrecommended medications.The P2Y12 response unit(PRU)was detected 1 week after taking ticagrelor,and the incidence of major adverse cardiovascular events(MACE)and bleeding events was compared between the two groups within 1 year follow-up.Results The PRU of patients in low-dose group(85.23±21.15)U,was higher than that of standard-dose group(54.96±15.22)U(P<0.05).The total bleeding events and minor bleeding events of low-dose group were lower than those of standard dose group separately(total bleeding time 19.5%vs 34.5%,minor bleeding events 11.5%vs 24.8%)(P<0.05),HR and 95%CI were 0.564(0.351-0.905)and 0.464(0.254-0.849).The major bleeding events and MACE were not clinically significant between two groups(P>0.05).Conclusion The low-dose ticagrelor was as effective as standard dose in non-left main acute myocardial infarction patients,and might significantly reduce risk of minor bleeding.
作者
林少沂
杜为平
胡豪畅
成绩
朱云云
皇甫宁
周宏林
LIN Shaoyi;DU Weiping;HU Haochang;CHENG Ji;ZHU Yunyun;HUANGFU Ning;ZHOU Honglin(Department of Cardiology,Ningbo First Hospital,Ningbo 315010,China)
出处
《心电与循环》
2021年第3期255-257,281,共4页
Journal of Electrocardiology and Circulation
基金
浙江省医药卫生科技计划项目(2020KY822)
宁波市自然科学基金(2017A610209)
宁波市社会发展科技攻关项目(202002N3175、2014C50071)。
关键词
低剂量
血小板抑制剂
替格瑞洛
心肌梗死
主要心血管不良事件
Low dose
Platelet aggregation inhibitors
Ticagrelor
Mocardial infarction
Major cardiac adverse events
