The Retrospective Study Of The Influence Of Pantoprazole To The Clinical Outcomes Concerned With Adverse Cardiovascular Events And Upper Gastrointestinal Hemorrhage In The CAD Patients After PCI Combined With Clopidogrel

Objective: this study was aimed to evaluate the effects of pantoprazole on the rates of adverse cardiovasular events and upper gastrointestinal hemorrhage of CAD patients after PCI combined with clopidogrel.Methods: 726 CAD patients with PCI(collected from Shanghai Tongren Hospital between Jan 1st, 2008 and Dec 31 th,2013) were divided into four groups,A1 group included 127 patients who had ever taken pantoprazole for 7 to 30 days in the later year after PCI; A2 group included 58 patients who had ever taken pantoprazole for 31 to 60 days in the later year after PCI; A3 group included 21 patients who had ever taken pantoprazole for 61 days to 1 year in the later year after PCI; the contrast group is B,which included 520 patients who had never use pantoprazole or any other PPI. All the patients were all prescribed clopidogrel 300 mg before PCI, clopidogrel 75 mg and aspirin 100 mg daily after PCI. The clinical outcomes of the selected patients were all investigated, the rates of cardiovascular adverse events and upper gastrointestinal hemorrhage among the four groups were compared. The data were processed by the statistic software SPSS 20.0, the measurement data were shown as(?x±s),the variance between two groups were compared using independent samples T test, the analysis of variance was used to compare the differences among the multiple groups with further LSD multiple comparison between two groups; the numeration data were compared by X2 test and Fisher’s exact test, P <0.05 was defined as statistically significant.Results: The comparison of the adverse cardiovascular events: in A1, A2, A3 and B group,the rates of death caused by cardiovascular events respectively are 3.15%、3.45%、4.76% vs 4.04%,the rates of myocardial infarction respectively are 3.93%、3.45%、4.76% vs 4.04%, the rates of heart failure respectively are 5.51%、5.17%、9.52% vs 7.50%, the rates of angina pectoris respectively are 14.96%、13.79%、14.29% vs 13.26%,there were no significant statistic differences among the four groups(P>0.05). The rates of upper gastrointestinal hemorrhage in A1, A2, A3 and B group respectively are 6.29% 、5.17%、0.00% vs 9.23%,the differences among groups are statistical significant(P<0.05), and further pairwise comparison indicates the rates of upper gastrointestinal hemorrhage in A1,A2 and A3 group were all significantly lower than B group, that in A3 group was also significantly lower than those in A1 and A2 group.Conclusions: Pantoprazole didn’t increase the rates of adverse cardiovascular events such as cardiovascular death, myocardial infarction, heart failure and angina pectoris combined with clopidogrel in CAD patients after PCI; Pantoprazole could decrease the rate of upper gastrointestinal hemorrhage in those patients, while a more than 60 days’ therapy may get better results.