Application of thromboelastography in patients taking antiplatelet therapy after vertebrobasilar artery stenting
Objective To compare the clinical efficacies of using the results of thromboelastography(TEG)to guide the selection of antiplatelet aggregation drugs after vertebrobasilar artery stenting and the conventional use of antiplatelet aggregation drugs.Methods This was retrospective analysis.Sixty-nine patients taking vertebral-basilar artery stenting at Department of Neurology,Second Hospital Affiliated to Fujian University of Traditional Chinese Medicine from July 2018 to June 2023 were selected as the study objects.They orally took aspirin enteric-coated tablets,100 mg/d,qd,and clopidogrel tablets,75 mg/d,qd.The patients whose antiplatelet therapy was adjusted according to the results of thrombologram parameters were set as an adjusted group(53 cases),and the patients whose therapy was not adjusted were set as a control group(16 cases).There were 43 males and 10 females in the adjusted group;they were(68.53±11.4)years old.There were 12 males and 4 females in the control group;they were(68.50±9.28)years old.The adjusted group's therapy was adjusted as below:if the controlled rate of arachidonic acid(AA)was not qualified,the patients took indobufen tablets(100 mg,bid)or cilostazol tablets(100 mg,bid)instead of aspirin enteric-coated tablets;if the controlled rate of adenosine diphosphate(ADP)was not qualified,the patients took ticagrelor tablets(90 mg,bid)instead of clopidogrel tablets,for 6 months.The control group continued to orally take aspirin enteric-coated tablets(100 mg,qd)and clopidogrel tablets(75 mg,qd)for 6 months.The levels of total cholesterol,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triacylglycerol(TG),creatinine(Cr),uric acid(UA),and fibrinogen(FIB)and the incidences of ischemic events,bleeding events,stent restenosis,and death within 6 months after operation were compared between the two groups.The independent sample t test,Mann-Whitney U test,x2 test,and Fisher's precision probability test were applied.Results There were no statistical differences in the levels of CHOL,HDL-C,LDL-C,TG,Cr,UA,and FIB before and 6 months after the operation between the two groups(all P＞0.05).Within 6 months after operation,the incidences of ischemic events and stent restenosis in the adjusted group were lower than those in the control group[18.87％(10/53)vs.68.75％(11/16)and 7.55％(4/53)vs.31.25％(5/16)],with statistical differences between the two groups(x2=12.184,P＜0.001;x2=4.177,P=0.041).One case(1.89％)had brain bleeding in the adjusted group,and none in the control group,with no statistical difference between the two groups(P=1.000).Conclusion The use of thromboelastography to guide the individualized antiplatelet therapy for patients after vertebrobasilar artery stenting has better clinical prognosis than the traditional standard therapy.
万方数据
维普
