Efficacy And Safety Of Treatment On The Elderly ST Segment Elevation Myocardial Infarction With Indobufen And Clopidogrel

Objective:To observe the efficacy and safety of treatment on the elderly ST segment elevation myocardial infarction with indobufen and clopidogrel.Methods:A total of 60 patients diagnosed as ST-segment elevation myocardial infarction with previous digestive system diseases in the fifth department of cardiology belong to the Second Hospital of Hebei Medical University were enrolled.They were randomly divided into observation group(n=30)and control group(n=30).The patients were given loading dose of 200 mg indobufen and 300 mg clopidogrel for the first time,and then given aspirin 100 mg once daily and clopidogrel 75 mg once daily in observation group.While in the control group: Patients were given a loading dose of 300 mg aspirin and 300 mg clopidogrel for the first time,and then a maintenance dose of aspirin 100 mg once daily and clopidogrel 75 mg once daily.The platelet parameters(platelet count,mean platelet volume,platelet distribution width,platelet hematocrit),arachidonic acid(AA)and adenosine diphosphate(ADP)-induced platelet aggregation rate(PAR)and degree of inhibiton and coagulation index(prothrombin time,thrombin time,activated partial thromboplastin time,international standard ratio)were compared two groups.The clinical treatment effect of the selected patients for 3 months and the occurrence of cardiovascular events(Including recurrent angina pectoris,myocardial infarction,stroke,acute or subacute stent thrombosis,cardiac death,etc.)were counted.The adverse events(bleeding,gastrointestinal symptoms,and drug allergies)were recorded during follow-up.Results:There was no statistical difference in platelet parameters between the two groups before and after treatment(P> 0.05).The platelet aggregation rate(AA,ADP)was significantly lower after administration than before administration(P <0.05),while the degree of inhibition of platelet aggregation rate induced by AA(0.21 ± 0.06 vs 0.21 ± 0.05)and the degree of inhibition of platelet aggregation rate induced by ADP(0.41 ± 0.08 vs 0.40 ± 0.09)has no statistical difference(P> 0.05).APTT,PT,TT,and INR were all higher than before administration,and had statistical differences(P <0.05),the inhibition rate of platelet aggregation induced by AA(0.21 ± 0.06 vs 0.21 ± 0.05)and the inhibition rate of platelet aggregation induced by ADP(0.41 ± 0.08 vs 0.40 ± 0.09)were not statistically different between the two groups(P> 0.05).APTT,PT,TT,and INR in blood coagulation indicators were significantly higher than before administration(P <0.05),and the degree of increase was similar between the two groups(P> 0.05),but it is worth noting that the baseline values of the increase in the APTT,PT,TT and INR observation groups were higher than those in the control group.There were no statistical differences in clinical efficacy(93.3% vs 90%)in the 60 patients with STEMI within 3 months of follow-up.During this period,2 cases of angina occurred in the observation group,1 case of stent thrombosis 2 cases of angina occurred in the control group.There was no statistical difference in the incidence of cardiovascular events between the two groups.Compared with the control group,the incidence of adverse reactions in the observation group was significantly lower(P <0.05).Conclusion:Indobufen combined with clopidogrel can effectively inhibit platelet aggregation rate,and the clinical efficacy is not statistically different from the antiplatelet therapy with aspirin and clopidogrel.Indobufen had lower incidence of adverse events,which had good clinical efficacy and safety.