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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
黄毅雄,刘如晨,郑建勇,李贤峰,曹 毅,刘英明,李田昌*.替格瑞洛对高龄非ST段抬高型急性冠脉综合征患者疗效及安全性的回顾性分析[J].中华老年多器官疾病杂志,2016,15(10):749~752
替格瑞洛对高龄非ST段抬高型急性冠脉综合征患者疗效及安全性的回顾性分析
Efficacy and safety of ticagrelor for the very old patients with non-ST-elevation acute coronary syndrome: a retrospective analysis of 202 cases
投稿时间:2016-06-07  
DOI:10.11915/j.issn.1671-5403.2016.10.178
中文关键词:  替格瑞洛;氯吡格雷;老年人;非ST段抬高型急性冠脉综合征;经皮冠状动脉介入治疗
英文关键词:ticagrelor; clopidogrel; aged; non-ST-elevation acute coronary syndrome; percutaneous coronary intervention
基金项目:
作者单位E-mail
黄毅雄,刘如晨,郑建勇,李贤峰,曹 毅,刘英明,李田昌* 解放军海军总医院心脏中心, 北京 100048 ltc909@aliyun.com 
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中文摘要:
      观察替格瑞洛在高龄非ST段抬高型急性冠脉综合征(NSTE-ACS)患者中的疗效与安全性。方法 连续选取海军总医院心脏中心2014年1月至2015年6月住院期间的高龄(年龄≥75岁)NSTE-ACS患者202例,根据抗血小板策略不同分为替格瑞洛组(86例)和氯吡格雷组(116例)。替格瑞洛组给予替格瑞洛180 mg负荷量后90 mg,口服,2次/d;氯吡格雷组给予氯吡格雷300 mg负荷量后75 mg,口服,1次/d,观察1年内两组患者的主要不良心脑血管事件(MACCE)发生率、严重心肌缺血复发率及出血情况。结果 替格瑞洛组发生MACCE 4例(47%),氯吡格雷组发生MACCE 16例(138%),两组患者MACCE发生率差异具有统计学意义(P=0.030)。替格瑞洛组复发严重心肌缺血4例(47%),氯吡格雷组复发严重心肌缺血8例(69%),两组患者严重心肌缺血复发率差异无统计学意义(P=0.495)。替格瑞洛组发生出血情况7例(81%),氯吡格雷组发生出血情况8例(68%),两组患者出血发生率差异无统计学意义(P=0.752)。结论 高龄NSTE-ACS行冠状动脉介入治疗患者给予替格瑞洛治疗可改善预后,且不增加出血风险。
英文摘要:
      Objective To investigate the efficacy and safety of ticagrelor in the treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in the very old patients. Methods Consecutive senior NSTE-ACS patients (≥75 years old) admitted in our hospital from January 2014 to June 2015 were enrolled in this study. According to the anti-platelet strategies, the 202 subjects were divided into ticagrelor group (n=86, initially oral loading dose of 180 mg and then continue with 90 mg twice daily) and clopidogrel group (n=116, initially oral loading dose of 300 mg and then continue with 75 mg daily). All patients were followed up for 12 months after percutaneous coronary intervention (PCI) for the incidences of major adverse cardiac and cerebral events (MACCE), recurrent myocardial ischemia and bleeding events. Results MACCE occurred in obviously fewer patients of the ticagrelor group (4 cases/4.7%) than in the clopidogrel group (16 cases/13.8%, P=0.030). Recurrent myocardial ischemia was observed in 4 cases (4.7%) from the ticagrelor group, and in 8 cases (6.9%) out of the clopidogrel group, but there was no significant difference between them (P=0.495). There were 7 cases (8.1%) of bleeding events in the ticagrelor group, and 8 cases (6.8%) in the clopidogrel group, though without significant difference between them (P=0.752). Conclusion Ticagrelor treatment can improve the prognosis and has no effect in increasing the bleeding risk in the very old NSTE-ACS patients after undergoing PCI.
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