The Study On The Effect Of Cilostazol And Aspirin Combined Separately With Clopidogrel On Platelet Aggregation Ratio In CHD Patients

Objective: This study compared the effect of cilostazol and aspirin combined separately with clopidogrel on platelet aggregation ratio by measuring the maximum aggregation rate(MAR%)of platelets induced by adenosine diphosphate(ADP)and arachidonic acid(AA)before and after taking the medicine in patients with coronary heart disease.The incidence of major adverse cardiovascular events(MACE)and hemorrhagic events were observed between the two groups at the same time.Methods: A total of 187 CHD patients diagnosed by coronary angiography or coronary CT angiography examination at Affiliated Hospital of North Sichuan Medical College from January 2018 to October 2018 were chosen for the study.General clinical data were collected from 187 patients,including age,gender,height,weight,BMI,smoking history,history of hypertension,history of diabetes,history of cerebrovascular disease,medication for CHD,coronary angiography or coronary CTA data,biochemistry,blood routine,echocardiography,carotid duplex ultrasound et al.All patients enrolled were tested for MAR% induced by ADP and AA before and after taking the medicine by PL-11 platelet function analyzer.Patients with CHD were divided into cilostazol group(group A,cilostazol plus clopidogrel)and aspirin Group(group B,aspirin plus clopidogrel)according to the antiplatelet regimen;50 healthy subjects in the physical examination center of the Affiliated Hospital of North Sichuan Medical College during the same period were divided into blank control group(Group C).1.Analyze the differences of age,sex,BMI,high risk factors of coronary heart disease,biochemical indicators,platelet count(PLT),mean platelet volume(MPV)among the three groups.2.Compare the MAR% changes before and after taking antiplatelet medicine in group A and B.3.Conduct 3-month follow-up to compare the incidence of major adverse cardiovascular events(MACE)and hemorrhagic events between groups A and B.The results were analyzed by SPSS23.0 software.Results: 1.The use rate of beta blocker(?-blocker),proton pump inhibitor(PPI),TC,LDL-C,VLDL-C and apo-B1 in group A were lower than those in group B,and the age,HDL-C,UA and MPV were higher than those in group B,whose difference was statistically significant(P<0.05).There were no significant differences in terms of gender,CHD risk factors,ACEI/ARB,low molecular weight heparin usage rate,LVEF,BMI,Hcy,TG,apo-A1,Lp(a),hs CRP,PLT and the extent of coronary artery lesion stenosis(Gensini Score)(P>0.05).2.The MAR% of patients in group A and B was higher than that in group C before taking medicine,and the MRA% of patients in both group A and B was decreased after taking medicine(P<0.05),but there was no significant difference in the MAR% of patients between group A and B before and after taking medicine(P>0.05).3.No extent of coronary artery lesion stenosis(Gensini Score)was found to be associated with maximum platelet aggregation rate(MAR%)and MPV before taking the medicine(P>0.05).4.After 3 months of follow-up,there was no significant difference in the incidence of MACE between group A and group B(P>0.05).There was no TIMI major hemorrhage in both groups during the follow-up period.The incidence of minor hemorrhage events in group A was lower than that in group B,but there was no significant difference in the incidence of minor hemorrhage between the two groups(P>0.05);the incidence of minor hemorrhage events in group A was lower than that in group B(4.34% vs 17.73%),and the difference was statistically significant(P<0.05).Conclusion: The antiplatelet regimen inhibits the maximum platelet aggregation rate of cilostazol and aspirin combined separately with clopidogrel was similar,and there was no significant difference in the incidence of MACE and the incidence of bleeding between group A and B.