不同的双抗治疗方案对急性心肌梗死患者PCI术后血脂、冠状动脉血流状态、纤溶及凝血系统稳定性的影响

doi:10.3969/j.issn.1671-7171.2025.11.012

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Abstract 【Objective】To explore the effects of different dual antiplatelet therapy (DAPT) regimens on blood lipids, coronary artery blood flow status, and fibrinolytic and coagulation system stability in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). 【Methods】The clinical data of 100 AMI patients who underwent PCI in our hospital from April 2022 to June 2024 were analyzed retrospectively. According to different treatment regimens, the patients were divided into an observation group (n=48, treated with aspirin + ticagrelor DAPT regimen after surgery) and a control group (n=52, treated with conventional aspirin + clopidogrel DAPT regimen after surgery). Both groups received continuous treatment for at least 24 weeks. Blood lipid indexes [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], coronary artery blood flow status indexes [corrected TIMI frame count (CTFC), coronary flow velocity reserve (CFVR), peak systolic velocity (PSV)], and fibrinolytic and coagulation system indexes [platelet aggregation rate, fibrinogen (FIB), tissue-type plasminogen activator (t-PA), antithrombin Ⅲ (AT-Ⅲ)] were compared between the two groups. The incidence of bleeding events and major adverse cardiovascular events (MACE) during treatment was counted in both groups. 【Results】After 24 weeks of treatment, the serum levels of TG, TC, and LDL-C in both groups were lower than those before treatment, while HDL-C was higher than that before treatment; the serum HDL-C level in the observation group was higher than that in the control group, and LDL-C was lower than that in the control group, with statistically significant differences (P<0.05); there were no statistically significant differences in serum TG and TC between the two groups (P>0.05). After 24 weeks of treatment, CFVR and PSV in both groups were higher than those before treatment, and CTFC was lower than that before treatment, with statistically significant differences (P<0.05); there were no statistically significant differences in CFVR, PSV, and CTFC between the two groups (P>0.05). After 24 weeks of treatment, t-PA and AT-Ⅲ in both groups were higher than those before treatment, and platelet aggregation rate and FIB were lower than those before treatment; t-PA and AT-Ⅲ in the observation group were higher than those in the control group, and platelet aggregation rate and FIB were lower than those in the control group, with statistically significant differences (P<0.05). There were no statistically significant differences in the cumulative incidence of bleeding events and MACE between the two groups (all P>0.05). 【Conclusion】Both DAPT regimens can well improve the coronary artery blood flow status of AMI patients after PCI with high safety; however, the aspirin + ticagrelor DAPT regimen can better regulate the patients' blood lipid levels and is more conducive to the stability of the fibrinolytic and coagulation systems.

Key words： Myocardial Infarction Acute Disease Percutaneous Coronary Intervention Hemodynamics Blood Coagulation

Received: 01 July 2025

PACS:

R542.22

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	HU Yanan
	HUA Pengduo
	LIU Yang

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HU Yanan,HUA Pengduo,LIU Yang. Effects of Different Dual Antiplatelet Therapy Regimens on Blood Lipids, Coronary Artery Blood Flow Status, and Fibrinolytic and Coagulation System Stability in Patients with Acute Myocardial Infarction after PCI[J]. JOURNAL OF CLINICAL RESEARCH, 2025, 42(11): 1883-1886.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.11.012 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I11/1883

[1] KOH T,HUANG W,GAO F,et al. Adherence to optimal medical therapy in Asian patients with acute myocardial infarction treated with PCI[J].Eur Heart J,2020,41(1):259.
[2] 易涛,沈健,罗素新,等. 溶栓后PCI与直接PCI治疗急性ST段抬高型心肌梗死的疗效对比研究[J].重庆医学,2020,49(23):3958-3961.
[3] 陈奇, 刘洋, 姬劲锐, 等. 西洛他唑联合氯吡格雷及阿司匹林对AMI病人PCI术后出血事件、凝血功能的影响[J].中西医结合心脑血管病杂志, 2022, 20(7): 1279-1283.
[4] 李晓渝,储岳峰,胡文杰.硫酸氢氯吡格雷片联合阿司匹林治疗急性心肌梗死患者的临床研究[J].中国临床药理学杂志,2020,36(15):2182-2185.
[5] 栗佳男, 王勇, 邱洪, 等. 替格瑞洛与氯吡格雷在接受经皮冠状动脉介入治疗的稳定型冠心病患者中的有效性和安全性比较[J].中国分子心脏病学杂志,2023,23(3):5374-5379.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疔指南[J].中华心血管病杂志,2015,43(5):380-393.
[7] 祝海香,叶志弘,金金花,等.急性心肌梗死患者心脏康复知识与态度的调查研究[J].中华护理杂志,2020,55(1):78-83.
[8] 李拜红,施晶晶,鲍骏,等.替格瑞洛片联合阿司匹林肠溶片用于经皮冠状动脉介入治疗术后急性心肌梗死患者的临床研究[J].中国临床药理学杂志,2021,37(19):2558-2561.
[9] 黄村榕,刘炜达,杨进刚,等.中国ST段抬高型心肌梗死患者初始他汀类药物用药强度与远期预后的相关性研究[J].中国循环杂志,2020,35(6):560-565.
[10] 徐慧慧, 谢艳辉, 宋恒良,等. PCSK9抑制剂对急性ST段抬高型心肌梗死PCI术后的微循环功能及左心室重构的影响[J].临床心血管病杂志,2022,38(1):22-28.
[11] 黄景慧, 张利利, 宁萌,等. PCI术后普伐他汀联合氯吡格雷对老年急性心肌梗死患者心肌损伤及NT-proBNP、脂蛋白a、sd-LDL水平的影响[J].中国老年学杂志,2021,41(20):4335-4338.
[12] 朴正姬.阿托伐他汀钙片联合替格瑞洛片治疗冠心病不稳定型心绞痛患者的临床效果探讨[J].中国现代药物应用,2021,15(22):123-125.
[13] 俞峰,吴峰,郑毅敏,等. 冠心宁片对急性心肌梗死经皮冠脉介入术后患者心肌灌注水平及炎症反应的影响[J].中国现代医学杂志,2021,31(10):60-64.
[14] OZKALAYCI F, TÜRKYLMAZ E, KARAGOZ A, et al. A clinical score to predict "corrected thrombolysis in myocardial infarction frame count" in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention[J].Angiology,2022,73(4):365-373.
[15] 郭宝亮, 李占鲁. 参松养心胶囊联合氯吡格雷对老年急性冠脉综合征经皮冠状动脉介入术后血流及预后的影响[J].中华中医药学刊,2021,39(5):210-212.