PCI的止血方面:慢性冠状动脉综合征患者既往双重抗血小板治疗背景下凝血血小板链活性的围手术期改变

Nataliia I. Kozachyshyn, Vasyl Z. Netiazhenko, Sergii V. Salo
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 Materials and methods. We examined 67 patients (mean age 65.2±8.6 years) who were undergoing inpatient treatment at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. Patients with different regimens of antiplatelet therapy were compared before and after PCI. At the time of hospitalization, patients were receiving both monotherapy and dual antiplatelet therapy (those with a history of myocardial infarction up to 12 months) in standard doses. The control group consisted of 25 people of similar age (62.7±6.5 years). The activity of platelet hemostasis was evaluated by the turbidimetric method and the light transmission fluctuation method. Statistical processing was carried out using the MedStat v.5.2 and Statistica 8.0 software.
 Results. Before PCI, dual antiplatelet therapy using aspirin and ticagrelor suppressed the activity of platelet hemostasis, compared to dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Patients receiving monotherapy did not achieve the desired effect. After PCI, the group of patients who took the combination of aspirin and ticagrelor responded better to the therapy than those who received aspirin and clopidogrel.
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引用次数: 0

摘要

的目标。分析慢性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)前后凝血血小板链活性的变化及既往抗血小板治疗背景。 材料和方法。我们检查了67例在乌克兰国家医学科学院国立阿莫索夫心血管外科研究所住院治疗的患者(平均年龄65.2±8.6岁)。比较PCI术前和术后不同抗血小板治疗方案的患者。住院时,患者接受标准剂量的单药和双抗血小板治疗(有心肌梗死史达12个月的患者)。对照组年龄相近(62.7±6.5岁)25例。采用浊度法和透射波动法评价血小板止血活性。使用MedStat v.5.2和Statistica 8.0软件进行统计处理。 结果。PCI前,与乙酰水杨酸和氯吡格雷双重抗血小板治疗相比,阿司匹林和替格瑞洛双重抗血小板治疗可抑制血小板止血活性。接受单药治疗的患者未达到预期效果。PCI术后,联合服用阿司匹林和替格瑞洛的患者比联合服用阿司匹林和氯吡格雷的患者对治疗的反应更好。结论。使用乙酰水杨酸和替格瑞洛双重抗血小板治疗可减少自发聚集和诱导聚集。
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Hemostasiological Aspects of PCI: Periprocedural Changes in the Activity of the Platelet Link of Hemocoagulation on the Background of Prior Double Antiplatelet Therapy in Patients with Chronic Coronary Syndrome
The aim. To analyze changes in the activity of the platelet link of hemocoagulation in patients with chronic coronary syndrome before and after percutaneous coronary intervention (PCI) against the background of prior antiplatelet therapy. Materials and methods. We examined 67 patients (mean age 65.2±8.6 years) who were undergoing inpatient treatment at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. Patients with different regimens of antiplatelet therapy were compared before and after PCI. At the time of hospitalization, patients were receiving both monotherapy and dual antiplatelet therapy (those with a history of myocardial infarction up to 12 months) in standard doses. The control group consisted of 25 people of similar age (62.7±6.5 years). The activity of platelet hemostasis was evaluated by the turbidimetric method and the light transmission fluctuation method. Statistical processing was carried out using the MedStat v.5.2 and Statistica 8.0 software. Results. Before PCI, dual antiplatelet therapy using aspirin and ticagrelor suppressed the activity of platelet hemostasis, compared to dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Patients receiving monotherapy did not achieve the desired effect. After PCI, the group of patients who took the combination of aspirin and ticagrelor responded better to the therapy than those who received aspirin and clopidogrel. Conclusions. The use of dual antiplatelet therapy with acetylsalicylic acid and ticagrelor reduced both spontaneous and induced aggregation.
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审稿时长
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