Application and efficacy of antiplatelet drugs in elderly patients with coronary heart disease

TIAN Guo-xiang; FENG Yan; YAO Lu; WU Yun-tao; XIA Chang-quan; LI Juan; ZHANG Wei; ZHU Li-zhang

doi:10.3969/j.1674-4055.2015.03.31

Abstract：Objective To analyze the application and efficacy of antiplatelet drugs in elderly patients with coronary heart disease (CHD). Methods The elderly CHD patients (age≥75, n=75) were chosen from June 2013 to Dec. 2014, and divided into dual antiplatelet therapy group (antiplatelet group, n=32), aspirin group (n=16), clopidogrel group (n=12) and control group (without taking antiplatelet drugs, n=15). The indexes of coagulation function and thrombelastogram (TEG) were compared among antiplatelet group, aspirin group and clopidogrel group. Results In 75 elderly patients, 42.7% of them took dual antiplatelet drugs, 21.3% took only aspirin, 16.0%took only clopidogrel and 20.0%did not take antiplatelet drugs. The constitution of age and sex, routine coagulation indexes and platelet count (PLT) had no statistical difference among antiplatelet group, aspirin group and clopidogrel group (P<0.05). In aspirin group, IRAA>50%induced by arachidonic acid (AA) in 97.9%patients, and in clopidogrel group IRADP≥30%induced by ADP in 70.5%patients. The levels of R, K, Angle and MA had no statistical difference among antiplatelet group, aspirin group and clopidogrel group (P>0.05), and MAADP, IRADP and IRAA had statistical difference (P<0.05) among antiplatelet group, aspirin group and clopidogrel group. MAADP was significantly lower (P<0.05), and IRADP was significantly higher (P<0.05) in antiplatelet group than those in aspirin group and clopidogrel group, and IRAA was significantly lower in clopidogrel group than that in antiplatelet group and aspirin group (P<0.05). Conclusion The usage rate of antiplatelet drugs is higher in elderly CHD patients, and aspirin and clopidogrel have better efficacy of antiplatelet but incidence of aspirin low reaction is lower than that of clopidogrel low reaction.