吲哚布芬联合替格瑞洛在伴阿司匹林禁忌症冠心病患者PCI术后的应用及安全性分析OA

Objective To analyze the application effect and safety of indobufen tablets combined with ticagrelor tablets in patients with coronary artery disease(CAD)complicated with aspirin contraindications after percutaneous coronary intervention(PCI).Methods Patients with CAD complicated with aspirin contraindications who underwent PCI were divided into control group and treatment group based on different treatment regimens.The control group received ticagrelor tablets at a loading dose of 180 mg every time and a maintenance dose of 90 mg every time,administered orally twice daily.The treatment group was added with oral administration of indobufen tablets at a dose of 0.1 g every time for twice daily based on the control group.Both groups were continuously treated for 6 months.The two groups were compared in terms of the clinical efficacy,changes in cardiac function,coagulation and inflammatory markers,occurrence of adverse drug reactions and incidence rates of major adverse cardiovascular events(MACE)within 1 year of follow-up.Results After adjusting for bias using the propensity score matching method(with the caliper value of 0.02,in a 1∶1 ratio),53 patients were ultimately enrolled in each group.After treatment,the overall effective treatment rate in the treatment group was 96.23％(51 cases/53 cases)and that in the control group was 84.91％(45 cases/53 cases),respectively;revealing a statistical difference(P＜0.05).After treatment,the left ventricular ejection fraction levels in the treatment and control groups were(56.28±4.13)and(51.64±4.01)％,respectively;cardiac troponin T levels were(20.11±2.84)and(24.16±3.31)ng·L-1,respectively;creatine kinase isoenzyme levels were(25.13±4.31)and(30.46±4.79)U·L-1,respectively;activated partial thromboplastin time(APTT)values were(26.52±1.67)and(26.78±1.72)s,respectively;fibrinogen levels were(3.14±0.51)and(3.71±0.55)g·L-1,respectively;D-dimer levels were(0.23±0.04)and(0.31±0.06)mg·L-1,respectively;C-reactive protein levels were(4.36±0.81)and(5.49±1.12)mg·L-1,respectively;and white blood cell counts were(5.97±1.10)× 109 and(6.81±1.25)× 109·L-1 respectively.With the exception of APTT,comparisons of the above indicators revealed statistically significant differences(P＜0.05).The two groups primarily experienced adverse drug reactions such as gastrointestinal reactions,bleeding and skin rash,and the overall incidence rates were 7.55％(4 cases/53 cases)and 5.66％(3 cases/53 cases)respectively,with no statistical difference(P＞0.05).After 1 year of follow-up,the overall incidence rates of MACE in the treatment and control groups were 5.66％(3 cases/53 cases)and 18.87％(10 cases/53 cases)respectively,with a statistical difference(P＜0.05).Conclusion The combination of indobufen and ticagrelor is more effective than ticagrelor alone in treating patients with CAD complicated with aspirin contraindications after PCI,and the former regimen can better improve cardiac function,coagulation status and inflammatory response,reduce the incidence rate of MACE,with good safety.