替格瑞洛和氯吡格雷在药物洗脱支架植入术后12个月内上消化道出血患者中的应用比较

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Abstract Objective To compare the safety and effectiveness of Ticagrelor and Clopidogrel in patients with upper gastrointestinal bleeding within 12 months after drug-eluting stent implantation. Methods A total of 108 patients with upper gastrointestinal bleeding after dual antiplatelet therapy for less than 12 months after second-generation drug-eluting stent implantation in Beijing Friendship Hospital from January 2016 to August 2019 were selected. According to the P2Y12 inhibitor received before upper gastrointestinal bleeding, they were divided into Ticagrelor group (45 cases) and Clopidogrel group (63 cases). The clinical characteristics were summarized and the cumulative incidence of ischemic and bleeding events was compared between the two groups. Results The proportion of percutaneous coronary intervention treatment for ST-segment elevation myocardial infarction and acute coronary syndrome in Ticagrelor group was significantly higher than that in Clopidogrel group(P ＜ 0.05). The incidence of non-target vessel revascularization in Ticagrelor group was lower than that in Clopidogrel group, the difference was statistically significant (P ＜ 0.05), there were no significant differences in the characteristics of complications, coronary artery lesions, target vessel reconstruction, incidence of major adverse cardiovascular events, and serious bleeding events between the two groups (P ＞ 0.05). Kaplan-Meier survival analysis showed that the cumulative incidence of non-target vessel revascularization in the Ticagrelor group was lower than that in the Clopidogrel group (P ＜ 0.05). Conclusion Ticagrelor versus Clopidogrel reduces the risk of coronary ischemic events and does not increase the risk of bleeding in patients with upper gastrointestinal bleeding within 12 months after second-generation drug-eluting stenting.

Key words： Percutaneous coronary intervention Upper gastrointestinal bleeding Antiplatelet therapy Ticagrelor Clopidogrel

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	HE Xiaoquan ZHOU Li GAO Xiangyu QIU Hui ZHAO Shumei SHEN Aidong CHEN Hui ZHAO Huiqiang▲

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HE Xiaoquan ZHOU Li GAO Xiangyu QIU Hui ZHAO Shumei SHEN Aidong CHEN Hui ZHAO Huiqiang▲. Comparison of Ticagrelor and Clopidogrel in patients with upper gastrointestinal bleeding within 12 months after drug-eluting stent implantation#br#[J]. 中国医药导报, 2021, 18(31): 100-103.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I31/100

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