Clinical study of thrombelastogram combined with CYP2C19 in the guidance of antiplatelet therapy in patients with acute coronary syndrome after percutaneous coronary intervention
Objective To explore the clinical value of thrombelastogram(TEG)combined with CYP2C19 in guiding an-tiplatelet therapy in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 270 patients with ACS who underwent PCI in Pingxiang People's Hospital from January 2020 to June 2023 were selected as the study objects,and they were divided into group A(without examination,n=115),group B(CYP2C19 gene detection,n=95),and group C(CYP2C19 combined TEG detection,n=60)according to the patients'will.The group A was routinely given Aspirin+Clopidogrel for anti-platelet therapy,group B was given Aspirin+Clopidogrel and Aspirin+Tica-grelor for anti-platelet therapy according to sensitivity of CYP2C19 gene,and group C was given Aspirin+Clopidogrel,As-pirin+Clopidogrel or Ticagrelor,Aspirin+Ticagrelor for antiplatelet therapy according to gene test and TEG monitoring re-sults.The patients were followed up for 6 months after PCI,bleeding events,major adverse cardiovascular events(MACE)and adverse drug reactions were compared in the three groups.Results There was no significant difference in the incidence of bleeding events among the three groups(P＞0.05).The total incidence of MACE of group A was higher than that in group B and group C,the difference was statistically significant(P＜0.017).There was no significant difference in the total inci-dence of adverse reactions among the three groups(P＞0.05).Conclusion Antiplatelet therapy under the guidance of TEG combined with CYP2C19 can reduce the risk of MACE in ACS patients after PCI,with high safety.
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维普
