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首页> 外文期刊>The American Journal of Cardiology >Effectiveness of Two-Year Clopidogrel + Aspirin in Abolishing the Risk of Very Late Thrombosis After Drug-Eluting Stent Implantation (from the TYCOON (Two-Year ClOpidOgrel Need) Study)
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Effectiveness of Two-Year Clopidogrel + Aspirin in Abolishing the Risk of Very Late Thrombosis After Drug-Eluting Stent Implantation (from the TYCOON (Two-Year ClOpidOgrel Need) Study)

机译：两年期氯吡格雷+阿司匹林消除药物洗脱支架植入后极晚血栓形成的风险的有效性（来自TYCOON（两年期ClOpidOgrel需要）研究）

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摘要

It remains unclear whether dual antiplatelet therapy > 12 months might carry a better prognosis after percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). To address the hypothesis that in the real world the risk of very late thrombosis after PCI with DESs can be decreased by an extended use of clopidogrel, we set up the Two-Year Clopidogrel Need (TYCOON) registry and prospectively investigated the impact on very late thrombosis of 12- versus 24-month dual antiplatelet regimens in an unselected population. The registry enrolled 897 consecutive patients who underwent PCI with stenting from January 1, 2003, to December 31, 2004, and had dual antiplatelet therapy. All patients had a 4-year clinical follow-up. In the 447 patients with DES implantation, the dual antiplatelet regimen after PCI was given for 12 months in the 173 patients treated in 2003 (12-month group) and for 24 months in the 274 patients treated in 2004 (24-month group). Comparison between groups did not reveal any significant difference in baseline clinical characteristics, angiographic and procedural features, and major adverse cardiac events. During follow-up, there were 5 cases of stent thrombosis after PCI in the 12-month DES group and 1 case in the 24-month DES group (p = 0.02). Specifically, there were 2 cases of subacute thrombosis (1 in each group), no case of late thrombosis, and 4 cases of very late thrombosis occurring at 13,15,17, and 23 months after DES implantation in the 12-month group only. In conclusion, a 2-year dual antiplatelet regimen with aspirin and clopidogrel can prevent the occurrence of very late stent thrombosis after PCI with DESs.
机译：使用药物洗脱支架（DES）进行经皮冠状动脉介入治疗（PCI）后，双抗血小板治疗> 12个月是否可以更好地预后尚不清楚。为了解决以下假设：在现实世界中，通过长期使用氯吡格雷可以降低DES导致PCI后发生晚期血栓形成的风险，我们建立了两年期氯吡格雷需求（TYCOON）注册中心，并前瞻性地研究了对晚期氯吡格雷的影响未选择人群的12个月和24个月双重抗血小板方案血栓形成。从2003年1月1日至2004年12月31日，该登记中心招募了897例连续行PCI支架置入术并接受双重抗血小板治疗的患者。所有患者均进行了为期4年的临床随访。在447例DES植入患者中，2003年接受治疗的173例患者（12个月组）给予PCI后双重抗血小板治疗12个月，2004年接受治疗的274例患者（24个月组）给予24天抗血小板治疗。两组之间的比较没有发现基线临床特征，血管造影和程序特征以及主要的不良心脏事件有任何显着差异。在随访期间，在12个月的DES组中有5例在PCI后发生支架内血栓形成，而在24个月的DES组中有1例（p = 0.02）。具体而言，仅12个月组有2例亚急性血栓形成病例（每组1例），无晚期血栓形成病例，在DES植入后13、15、17和23个月发生4例极晚期血栓形成病例。 。总之，使用阿司匹林和氯吡格雷的2年双重抗血小板方案可以预防DES介入治疗后发生晚期支架血栓的发生。

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