Safety Evaluation Of One-year Dual-antiplatelet Therapy After PCI In Coronary Heart Disease With Cerebral Infarction Patients

Objective:To investigate the safety of 1 year dual antiplatelet therapy(DAPT)applied to patients undergoing percutaneous coronary intervention(PCI)with a history of cerebral infarctionMethods:From January 2016 to July 2018,576 patients with coronary heart diseases who had undergone percutaneous coronary intervention(PCI)in the Department of Cardiology,The 920th hospital of the joint logistic support force of the PLA were retrospectively reviewed.One hundred and twenty-four cases were excluded from the study owing to their incomplete follow-up data the total remaining.452 patients were divided into two groups:cerebral infarction group(patients with history of cerebral infarction before PCI,n=50);no cerebral infarction group(patients without history of cerebral infarction before PCI,n=402).Clinical baseline data,coronary artery disease and treatment,relevant data during hospitalization,number of cardiovascular deaths at 6 months and 1 year after surgery,total number of deaths,number of recurrent cerebral infarction,number of recurrent myocardial infarction,and number of re-hospitalization due to target vessel re-revascularization and recurrent angina pectoris were collected.Statistical analysis was used to compare the changes ofdata.Results:1、There were significant differences in mean age(61.8±10.72 vs 66.16±8.47,P=0.006),comorbidities hypertension(80%vs 60.95%,P=0.008)and diabetes(38%vs 24.13%,P=0.034),preoperative calcium antagonist 17.66%vs 32%,P=0.015)(P<0.05)2、The recurrence rate of cerebral infarction in patients with cerebral infarction group was higher than that in patients without cerebral infarction group(4%vs 0%,P=0.012).There were no statistically significant differences in cardiovascular death.recurrent myocardial infarction,recurrent cerebral infarction and re-hospitalization between the two groups within 6 months of follow-up(P>0.05).There was no statistically significant difference in cardiovascular death,recurrence of myocardial infarction,and rehospitalization between the two groups within 1 year of follow-up.Multiple regression analysis showed that the history of cerebral infarction was not considered to have an effect on the recurrence of cerebral infarction 1 year after PCI in patients with coronary heart diseaseConclusion:(1)There were more risk factors in patients with cerebral infarction and coronary heart disease,such as age,history of hypertension and history of diabetes.(2)DAPT of 1 year is safe for patients with cerebral infarction and coronary heart disease.The history of cerebral infarction had no effect on the prognosis of patients with coronary artery disease undergoing percutaneous coronary intervention.