Application Of Thromboelastography In Patients Underwent PCI Treated With Antiplatelet Therapy:100Cases

Objective: According to the retrospective investigation into clinical records ofpatients who accepted the percutaneous coronary intervention (PCI) undergoingthe thrombelastography (TEG) examination, We analyzed the feature of clottingin different clinical types of coronary heart disease (CHD) patients，thecorrelationship of the reactivity of antiplatelet agents and recent ischemicevents, and discussed the practical applicability of TEG to antiplatelet therapymonitoring in the patients who accepted PCI．Method:100CHD patients withrelatively complete clinical data were adopted who had accepted PCI andmonitored antiplatelet therapy with TEG in The Affiliated Hospital Of LuZhouMedical College from Dec22nd,2012to Dec31st,2013．The patients weredivided into Acute Myocardial Infarction (AMI) group，Unstable AnginaPectoris (UAP) group and Stable Angina Pectoris (AP) group according toCHD clinical classification．To analysis the differences in coagulation indexesamong the groups. All patients were divided into low reaction group and normalgroup according to the platelet agglutination inhibition rate examed by TEGafter PCI. We compared the differences in coagulation indexes and ischemicevents happened in three months after hospitalization between the two groups.To analyze the correlationship between the reactivity of antiplatelet agents andrecent ischemic events.Result: The average age of the100patients were46.8± 8.7(32-62years old). There were31patients (31％) in AMI group,48patients(48％) in UAP group,21patients (21％) in SAP group.(1) Compared withSAP group, the R, K and APTT value decreased(P<0.01), the MA, Angle andFib value increased (P<0.05), and the frequency of high coagulate images ofTEG obviously get higher (P<0.05) in AMI group and UAP group.(2) Therewere significance differences in D-dimer among AMI group，UAP group andSAP group.2.There were31patients (31％) in low reaction to antiplateletdrugs group,69patients (69％) in normal group.(1) MA value were obvioushigher in low reaction to antiplatelet drugs group than in normal group(P<0.01).(2) The probability of ischemic events happened in three months afterhospitalization were obviously higher in low reaction to antiplatelet drugsgroup than in normal group (P<0.05). There were positive correlations betweenrecent ischemic events and low reaction to antiplatelet drugs group.Conclusion:1AMI group and UAP group compared with SAP group were in a relativelyhigh blood coagulation state.2There were positive correlations between recentischemic events and low reaction to antiplatelet drugs group.3TEG is aneffective method to monitor and guide the antiplatelet therapy after PCI.