| Objective: Coronary bifurcation lesions is common diseases in the treatment of coronary intervention,its operation is complicated and the occlusion rate is high,the probability of restenosis and stent thrombosis is high,it has become one of the difficulties and challenges in the treatment of PCI.The new antiplatelet drug ticagrelor is a potent P2Y12 receptor antagonist,a multinational,multicenter,double-blind,randomized PLATO study showed that compared with clopidogrel,ticagrelor can further improve the prognosis of patients with ACS.Ticagrelor is also an important application in China,it has obtained recommendation of NSTEMI-ACS guidelines,PCI guidelines and STEMI diagnosis and treatment guidelines.Compared with clopidogrel,there is no relevant research on the application of ticagrelor in the treatment of coronary bifurcation lesions.The purpose of this study is to investigate the efficacy and safety of percutaneous coronary intervention(PCI)after coronary artery bypass grafting in patients with coronary artery disease.Methods: This study selected 240 patients whose coronary bifurcation lesions were successfully treated with PCI in Internal Medicine-Cardiovascular Department of the Third Hospital of Xingtai from October 2013 to September 2014.After the operation,ticagrelors were given for treatment as the study group(120 cases),continue to clopidogrel in the treatment of patients as control group(120).The primary end point was the incidence of the two groups of patients were followed up for 1 years of major adverse cardiovascular events(MACE,including acute / subacute stent thrombosis,non fatal myocardial infarction and target vessel revascularization,cardiac death);SPSS 20 statistical software was used to analyze the measurement data with x + s,which was used for t test,and the data rate was expressed by the chi square test of 2.The difference has statistically significant with P < 0.05.Result: The main end point: The patients were followed up for 1,3,6,9 and 12 months,during the follow-up period,4 cases were lost in the study group and 8 cases were lost in the control group.The main adverse cardiovascular events occurred in 18 cases in the study group,the incidence was 15.5%,the control group occurred in 24 cases,the incidence was 21.4%,The incidence of major adverse cardiovascular events in the study group was lower than that in the control group,but the difference didn't has statistically significant(P>0.05).There were 4 cases of nonfatal myocardial infarction in the study group,the incidence was about 3.4%,the control group occurred in 14 cases,the incidence was 12.5%,The incidence of nonfatal myocardial infarction in the study group was deeply lower than that in the control group,the difference has statistically significant(P=0.036).Secondary end point: Ticagrelor 's main adverse events were bleeding events,and the bleeding events were classified into three categories: major bleeding,minor bleeding and mild bleeding.The major bleeding,minor bleeding,minor bleeding in the study group occurred in 2,3 and 7 cases,the incidence was 1.7%,2.6% and 6%,the total bleeding occurred in 12 cases,the incidence was 10.3%;the major bleeding,minor bleeding,minor bleeding in the control group occurred in 2,3 and 6 cases,the incidence was 1.8%,1.8% and 5.4%,the total bleeding occurred in 10 cases,the incidence was 8.9%;there was no significant difference in the incidence of bleeding events between the two groups(10.3% versus 8.9%,P=0.430).The study group was 11 cases of dyspnea,the incidence rate was 9.5%;the control group was 2 cases of dyspnea,the incidence rate was 1.8%,the difference has statistically significant(9.5% versus 1.8%,P = 0.011).Conclusion: Compared with clopidogrel,the application of ticagrelor in the treatment of coronary bifurcation lesions after the operation,it's clinical curative effect is equal,and does not increase the risk of bleeding,but the incidence of dyspnea is higher. |
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