| Objective To evaluate and analyze the clinical application of a new type of oral anticoagulant(NOACs)in patients with atrial fibrillation(AF)after percutaneous Coronary Intervention(PCI).The effectiveness and safety of dabigatran Etexilate.To analyze whether it can be an ideal choice for antithrombotic therapy after atrial fibrillation patients with PCI and its clinical significance with clopidogrel combined with antithrombotic therapy.Methods 72 patients with atrial fibrillation admitted to our hospital from 2016.11 to 2017.11 were treated with PCI.They were randomly divided into study group and control group,36 in each group.In the study group(n=36),21 male patients and 15 female patients;aged 56-75 years,mean age(60.38±5.73)years old;comorbid type: 9 cases of diabetes,15 cases of hypertension,14 cases of high Lipemia;control group(n=36),male patients in 23 cases,female patients in 13cases;age 56-72 years,mean age(62.01 ± 5.59)years;comorbid type: 12 cases of diabetes,14 cases of hypertension 13,13 cases of hyperlipidemia.The baseline data of the two groups were statistically calculated to obtain P>0.05,which can be used for comparative discussion and analysis.Subjects included criteria:(1)patients with persistent NVAF(non-valvular atrial fibrillation)aged 18 years or older;(2)patients with ACS who underwent PCI with drug-eluting stent(DES);Stability CAD patients into DES.Subject exclusion criteria: a patient with a history of fibrinolytic therapy within 2 hours;b.patients with a history of cerebral infarction or major bleeding within 3 months;c.patients with a history of cerebral hemorrhage within 6-12 months;d.Kidney damage(creatinine clearance CrCl<30mL/min).The study group received dabigatran etexilate 110 mg.bid +clopidogrel 75 mg.qd + aspirin 0.1 g.qd after PCI;1 week later changed to dabigatran etexilate 110 mg.bid + clopidogrel 75 mg.qd double antibiotic Suppository treatment;control group received triple therapy after surgery:warfarin(dose according to PT-INR adjustment: maintained at 2.0-2.5)+clopidogrel 75 mg.qd + aspirin 0.1g.qd triple therapy;3 months later changed to double Combination therapy: warfarin(dose according to PT-INR adjustment:maintained at 2.0-3.0)+ clopidogrel 75 mg.qd treatment.And followed up for 1year.Evaluation and comparison of postoperative adverse events and bleeding in the two groups.Statistical results were measured as mean ± standard deviation(±s),t-test was used for comparison between groups;count data was expressed as n(%),and chi-square test was used to compare dabigatran etexilate with clopidogrel.Efficacy and safety of antithrombotic therapy in patients with atrial fibrillation complicated with PCI.Results The incidence of adverse events in the study group and the control group was 8.33% in the study group and 11.11% in the control group.The difference was not significant(P>0.05).There was no statistical significance,that is,dabigatran etexilate combined with clopidogrel.Antithrombotic therapy was similar to warfarin triple antithrombotic therapy and did not increase the incidence of adverse events.The incidence of bleeding events between the study group and the control group: 1.The incidence of severe bleeding events: 2.78% in the study group and 8.33% in the control group,the difference was not significant(P>0.05),no statistical significance;2.Total bleeding events The incidence rate was 5.56% in the study group and 16.67% in the control group.The results were statistically significant(P<0.05),that is,dabigatran etexilate combined with clopidogrel double antithrombotic therapy was compared with warfarin triple antithrombotic therapy.It has high security.Conclusions The results of this study suggest that dabigatran etexilate combined with clopidogrel dual antithrombotic therapy can prevent adverse events while reducing bleeding in patients with atrial fibrillation complicated with PCI.There is a certain advantage in the incidence of events,and it has a certain guiding effect on the clinical use of some of these patients. |
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