Study on the application effect and optimal timing of switching dual antiplatelet therapy in patients with acute coronary syndrome who develop platelet hyperreactivity after PCI Wang Rong, Hu Nannan, Wang Jin, Lu Hui, Fu Kun [Abstract] Objective Analysis of dual Effects and optim

Study on the application effect and optimal time of switching dual antiplatelet therapy in patients with acute coronary syndrome who develop platelet hyperreactivity after PCI

Wang Rong, Hu Southeast, Wang Jin, Lu Hui, Fu Kun
[Abstract] Objective To analyze the application effect and optimal time of dual antiplatelet therapy (DAPT) switching in patients with acute coronary syndrome (ACS) who develop platelet hyperreactivity (HPR) after PCI. Methods 270 ACS patients who received DAPT after PCI were selected from Beijing Aerospace General Hospital from February 2019 to November 2020. They were divided into groups A, B, and C using the dice rolling method, with 90 cases in each group. The drug washout period was entered after 2 weeks, 1 month, and 3 months of treatment with the intensive DAPT regimen (aspirin + ticagrelor ) [1 week of treatment with the standard DAPT regimen (aspirin + clopidogrel )], Then 103 patients with HPR (48 patients in group A, 35 patients in group B, and 20 patients in group C) were selected as the research subjects, and the dice method was used again to divide them into conversion subgroup A (treated with standard DAPT regimen, 24 (cases) and A non-switching subgroup (continued to be treated with the intensive DAPT regimen, 24 cases), B converted subgroup (treated with the standard DAPT regimen, 17 cases) and B non-switching subgroup (continued to be treated with the intensive DAPT regimen, 18 cases) ), C conversion subgroup (treated with standard DAPT regimen, 10 cases) and C non-conversion subgroup (continued to be treated with intensive DAPT regimen, 10 cases). All patients were treated continuously for 1 year. Collect the general data of the patients and compare the incidence rates of cardiovascular and cerebrovascular adverse events and bleeding events in A conversion subgroup and A non-conversion subgroup, B conversion subgroup and B non-conversion subgroup, C conversion subgroup and C non-conversion subgroup. Incidence rate of cardiovascular and cerebrovascular adverse events in A, B, and C conversion subgroups. Results The incidence rate of cardiovascular and cerebrovascular adverse events in the A conversion subgroup was lower than that in the A non-conversion subgroup ( P <>0.05). Comparing the incidence rates of cardiovascular and cerebrovascular adverse events and bleeding events between the B conversion subgroup and the B non-conversion subgroup, there was no statistically significant difference (P>0.05). There was no statistically significant difference in the incidence of cardiovascular and cerebrovascular adverse events and bleeding events between the C conversion subgroup and the C non-conversion subgroup ( P > 0.05). The incidence of cardiovascular and cerebrovascular adverse events in A conversion subgroup was higher than that in B conversion subgroup ( P <> 0.05 ); There was no statistically significant difference in the incidence of cardiovascular and cerebrovascular adverse events between the B conversion subgroup and the C conversion subgroup (P>0.05). Conclusion The DAPT conversion strategy may reduce the risk of cardiovascular and cerebrovascular adverse events in ACS patients with HPR after PCI without increasing the risk of bleeding events, and has high clinical application value; and the optimal time for DAPT conversion is the intensive DAPT regimen. Treatment lasts for 1 month.
[Key words] Acute coronary syndrome; percutaneous coronary intervention; dual antiplatelet therapy; cardiovascular and cerebrovascular adverse events; bleeding events
[Chinese classification number] R 542.2 [Document identification code] A DOI: 10.12114/ j.issn.1008-5971.2022.00.171

Source of this article: Wang Rong, Hu Southeast, Wang Jin, et al. The application effect of dual antiplatelet therapy switching in patients with acute coronary syndrome who develop platelet hyperreactivity after PCI and its Study on the optimal time [J]. Journal of Practical Cardiocerebral and Pulmonary Vascular Diseases, 2022, 30 (7): 48-53.

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