Optimization of antithrombotic therapy strategy for stable coronary heart disease based on risks of is-chemia and bleeding

Fei Liang; Mao Yu; Chen Liangyu

doi:10.3969/j.issn.1674-4055.2024.10.21

Abstract：Objective To investigate the antithrombotic therapy strategy for stable coronary heart disease(CHD),and to improve the safety and effectiveness.Methods The patients with stable CHD(n=162,with high ischemia risk and low bleeding risk)were prospectively chosen from the Second Department of Cardiology in the First People's Hospital of Chuzhou City from Jan.2019 to Oct.2022.The patients were divided,by using random digital table,into control group and observation group(each n=81).The control group was given double antiplatelet therapy(aspirin combined with clopidogrel),and observation group was given double channel antithrombotic therapy(rivaroxaban combined with aspirin)for 6 months.The levels of platelet aggregation rate(PAG)and relative clinical indexes[platelet surface α-granule membrane glycoprotein(CO62P),endothelin-1(ET-1),nitric oxide(NO),fractional flow reserve(FFR),index of microcirculatory resistance(IMR)]and occurrence of major adverse cardiovascular events(MACE)and bleeding events during treatment were compared between 2 groups.Results After treatment for 6 months,PAG decreased in 2 groups,and PAG was lower in observation group than that in control group(P＜0.05).After treatment for 6 months,the levels of CO62P,ET-1 and IMR decreased,and levels of NO and FFR increased in 2 groups,while levels of CO62P,ET-1 and IMR were lower,and levels of NO and FFR were higher in observation group than those in control group(P＜0.05).The total incidence of MACE was lower in observation group than that in control group(P＜0.05).The incidence of bleeding events was slightly higher in observation group than that in control group during treatment(P＞0.05).Conclusion The double channel antithrombotic therapy can reduce PAG,relative clinical indexes and MACE risk,and does not increase bleeding risk in patients with stable CHD(with high ischemia risk and low bleeding risk).