Evaluation Of Efficacy And Safety Of Thromboelastography Combined With Platelet Aggregation Rate In Patients After PCI

Objective(s):To evaluate the efficacy and safety of thromboelastography combined with platelet aggregation rate in patients after PCI with bi-antibody therapy.Methods:1.Fifty patients with coronary heart disease who were hospitalized in the three cardiac wards of the Second Affiliated Hospital of Kunming Medical University and successfully underwent PCI were selected.All patients received 100 mg of aspirin enteric-coated tablets and 75 mg of clopidogrel bisulfate after operation.According to clinical symptoms,they were divided into event-free group,ischemic group and bleeding group.General data(gender,age),past history(smoking history,high level)of the three groups were collected.History of blood pressure,diabetes mellitus,body mass index(BMI),etc.2.The MA value of thromboelastogram,AA maximum aggregation rate(MARAA),ADP maximum aggregation rate(MARADP),blood cell count,blood biochemistry and other indicators of the two groups were collected.3.The baseline data and laboratory indicators(thromboelastogram,platelet aggregation rate,blood biochemistry,etc.)of the three groups were compared.4.The critical values,sensitivity and specificity of MA,ADP and AA were analyzed by ROC curve.5.Multivariate regression analysis was used to analyze the influencing factors of MA value,ADP maximum aggregation rate and AA maximum aggregation rate.6.Follow-up was conducted by means of Wechat,Telephone and Outpatient ServiceResults:1.There were significant differences in sex among the three groups,P<0.05.There were no significant differences in smoking history,BMI,diabetes mellitus,hypertension and age(P>0.05).2.There were no significant differences in platelet count,hemoglobin,uric acid,homocysteine,R value,K value,high density lipoprotein and low density lipoprotein among the three groups(P>0.05).3.There were significant differences in MA value,alpha angle,maximum aggregation rate of ADP and maximum aggregation rate of AA among the three groups(P<0.001).4.The results of ROC curve showed that MA value=63.05,ADP maximum aggregation rate=45.30,AA maximum aggregation rate=27.45 could be used as the critical point of ischemic events.When MA value=54.45,ADP maximum aggregation rate=18.35,AA maximum aggregation rate=32.75,it can be used as the critical point of bleeding events.5.Multiple linear regression analysis showed that smoking history,BMI,diabetes mellitus,hypertension,uric acid and homocysteine had no effect on MA value,ADP maximum aggregation rate and AA maximum aggregation rate.6.6.The rate of missing visits in outpatient combined telephone group was significantly higher than that in telephone combined with Wechat group and outpatient combined with Wechat group.There was no significant difference between telephone combined with Wechat group and outpatient combined with Wechat group.Conclusion(s):1.There are gender differences in effectiveness and safety.2.When MA value,ADP maximum aggregation rate and AA maximum aggregation rate are greater than and/or less than the critical value,they have the value of diagnosing ischemic events and/or hemorrhagic events.3.Thromboelastography combined with platelet aggregation rate detection can accurately evaluate the efficacy and safety of dual-antibody therapy.4.Joint follow-up with Wechat can effectively reduce the rate of lost follow-up.