Clinical Value of Thrombelastogram in Evaluating the Efficacy of Dual Antiplatelet Therapy in Elderly Patients with Coronary Heart Disease After Percutaneous Coronary Intervention (PCI)

doi:10.3969/j.issn.1004-5775.2025.07.014

Abstract：Objective: To explore the clinical value of thrombelastogram in evaluating the efficacy of dual antiplatelet therapy in elderly patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: A retrospective analysis was conducted on the clinical data of 93 elderly patients with coronary heart disease who underwent PCI at Dengzhou Central Hospital from January 2022 to October 2023. The patients were divided into three groups based on different types of diseases: stable angina pectoris (SAP) group (31 cases), unstable angina pectoris (UAP) group (27 cases), and acute myocardial infarction (AMI) group (35 cases). The coagulation indicators, thrombelastogram parameters, and the incidence of hypercoagulable patterns in the thrombelastogram were compared among the three groups. Results: The prothrombin time and activated partial thromboplastin time in the SAP group were significantly longer than those in the UAP and AMI groups, while the fibrinogen and D-dimer levels were significantly lower than those in the UAP and AMI groups. The international normalized ratio was significantly higher in the SAP group compared to the UAP and AMI groups, with statistically significant differences (F=8.651, 130.048, 14.534, 38.819, 26.257, P<0.05). The maximum amplitude, angle, the angle between the tangent line and horizontal line at the maximum curve arc, and the maximum amplitude of the thrombelastogram were significantly lower in the SAP group compared to the UAP and AMI groups. The clotting reaction time and clot formation time were significantly shorter in the SAP group compared to the SAP and UAP groups. The percentage reduction in amplitude 30 minutes after the maximum amplitude was significantly higher in the SAP group compared to the SAP and UAP groups, with statistically significant differences (F=12.959, 29.595, 10.936, 12.493, 8.414, 10.834, 116.615, P<0.05). The incidence of hypercoagulable patterns in the thrombelastogram was significantly lower in the SAP group compared to the UAP and AMI groups, with a statistically significant difference (x2=21.641, P<0.05). Conclusion: There are certain differences in coagulation indicators and thrombelastogram parameters among patients with different types of coronary heart disease. Thrombelastogram can be used to evaluate the efficacy of antiplatelet therapy in elderly patients with coronary heart disease after PCI, better monitor the platelet aggregation status, and guide the treatment of antiplatelet drugs, which is beneficial for patient prognosis.