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Triple Antiplatelet Therapy on the Evaluation of Short-term Prognosis of Unstable Angina Pectoris Patients after PCI

Author: HanGaoJie
Tutor: LiYongJun
School: Hebei Medical University
Course: Internal Medicine
Keywords: Load capacity cilostazol unstable angina pectoris percutan-eous coronary intervention high sensitivity C reactive protein myocardialinjury cardiovascular events
CLC: R541.4
Type: Master's thesis
Year: 2014
Downloads: 1
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Objective: Investigate the triple antiplatelet therapy on the evalua-tion of short-term prognosis of unstable angina pectoris patients after PCI, inorder to supply a clinical evidence for patients who were treated by PCI withpreoperative and postoperative antiplatelet choices.Methods: Selective PCI patients with UAP333cases (male188cases,females145cases) in our hospital were randomly divided into control groupwhich was double antiplatelet treatment therapy group(aspirin and clopidogrel,168cases) and triple antiplatelet therapy group (aspirin,clopidogrel andcilostazol,165cases).The day before PCI the dual antiplatelet therapy groupewas given aspirin and clopidogrel loading capacity300mg, after PCIaspirin was100mg once a day and clopidogrel75mg.While the day beforePCI the triple antiplatelet therapy groupe was given aspirin and clopidogrelload capacity300mg,load capacity for cilostazol was200mg,after PCIpatients in TT were given aspirin100mg once a day,clopidogrel75mg oncea day and cilostazol100mg twice a day.Observing in patients with highsensitivity C reactive protein(hs-CRP), cardiac markers,adverse cardiovas-cular and cerebrovascular events(MACCE)and bleeding events.Results:1There were no obvious differences in clinical characteristics[age, sex,hypertension, diabetes, smoking history, proton pump inhibitors(PPI),theaverage number of vascular lesions,the average number of stent implantationbetween the double groups](P>0.05).2Using hs-CRP as a sign of inflammatory injury, there was no strikingdifference between the two groups before PCI24h(4.67±0.56VS4.63±0.35,P=0.633).The follow-up24h hs-CRP there was a clear difference between the conventional treatment group and the TT group(7.69±0.75VS6.03±0.63,P<0.001).3Detect CK-MB and cTnI after PCI16h, the values were significantlyhigher than the preoperative ones(double antiplatelet group CK-MB:16.80±3.26VS11.30±2.38;cTnI:0.18±0.04VS0.06±0.03;triple antiplatelet groupCK-MB:14.30±2.78VS10.90±3.02;cTnI:0.11±0.03VS0.06±0.02). But after16h triple antiplatelet group compared with dual antiplatelet group CK-MBand cTnI were significantly decreased (CK-MB:16.80±4.3.26VS14.30±2.78,P<0.001;cTnI:0.18±0.04VS0.11±0.03,P=0.017).4After PCI30days the two groups had no serious bleeding to stop anti-platelet therapy in patients. In the dual antiplatelet therapy group there were6cases of a little bleeding and9cases of minor bleeding,while6cases of a littlebleeding and15cases of minor bleeding in the triple antiplatelet group.Therewas no obvious difference between the dule groups(10%VS14%,P=0.538).5Within PCI30days,there were3cases of cardiac death,9cases ofmyocardial infarction,6patients with revascularization and6patients withcerebral stroke in the dual antiplatelet therapy group.While in the tripleantiplatelet group,there were3cases of myocardial infarction and3patientswith revascularization.The incidence of MACCE in the triple anti-plateletgroup was lower than dual antiplatelet therapy group (16%VS4%, P=0.046).Conclusion: Compared with dual antiplatelet therapy, preoperative PCItriple antiplatelet therapy based on the load capacity of cilostazol can reducepostoperative inflammatory reaction and the incidence of MACCE after PCI.At the same time PCI does not increase the incidence of postoperative hemo-rrhage.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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