双联抗血小板治疗时程对冠状动脉非阻塞性心肌梗死患者临床结局的影响

doi:10.3969/j.issn.1006-6233.2025.02.015

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Abstract Objective: To investigate the effect of the duration of dual antiplatelet therapy (DAPT) on the outcome of non-obstructive coronary artery myocardial infarction (MINOCA). Methods: A total of 111 hospitalized patients examined with coronary angiography and diagnosed with MINOCA in Chengde Central Hospital from January 2016 to December 2023 were continuously enrolled. They were divided into the short-duration DAPT (1~3 months DAPT, n=59) and long-duration DAPT (3~6 months DAPT, n=52) based on the duration of DAPT. Kaplan-Meier analysis and Cox proportional hazard regression were performed to assess the effect of the duration of DAPT on the outcome of MINOCA. Results: The incidence of primary endpoints was 23.7% in the short-duration DAPT group, and 19.2% in the long-duration DAPT group, showing no significant difference (P=0.566). The Kaplan-Meier analysis also indicated comparable primary endpoints between the short-duration DAPT group and long-duration DAPT group (log-rank P=0.535). Cox regression analysis showed that in comparison to the short-duration DAPT group, a long duration of DAPT did not correlate with the reduced risk of primary endpoints (hazard ratio [HR]: 1.310, 95% confidence interval [CI]: 0.582~2.399, P=0.514). Moreover, there was no significant difference in the risk of type 1-5 Bleeding Academic Research Consortium (BARC) between the two groups (HR: 0.439, 95%CI: 0.080~2.399, P=0.342). Conclusion: Considering the similar incidence of ischemic event and lower incidence of bleeding, a short duration of DAPT may be superior to a long duration of DAPT in MINOCA patients.

Key words： Dual antiplatelet therapy Myocardial infarction with nonobstructive coronary arteries Outcome

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.02.015 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I2/264

[1] Byrne RA,Rossello X,Coughlan JJ,et al.2023 ESC guidelines for the management of acute coronary syndromes[J].Eur Heart,2023,44(38): 3720-3826.
[2] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高型急性冠脉综合征诊断和治疗指南(2024)[J].中华心血管病杂志,2024,52(6):615-646.
[3] Thygesen K,Alpert JS,Jaffe AS,et al.Fourth universal definition of myocardial infarction (2018)[J].Circulation,2018,138(20):618-651.
[4] Capodanno D,Mehran R,Krucoff MW,et al.Defining strategies of modulation of antiplatelet therapy in patients with coronary artery disease: a consensus document from the academic research consortium[J].Circulation,2023,147(25): 1933-1944.
[5] Ge Z,Kan J,Gao X,et al.Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised,placebo-controlled,double-blind clinical trial[J].Lancet,2024,403(10439): 1866-1878.
[6] Tamis-Holland JE,Jneid H,Reynolds HR,et al.Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American heart association[J].Circulation,2019,139(18):891-908.
[7] Pasupathy S,Air T,Dreyer RP,Tavella R,Beltrame JF.Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries[J].Circulation,2015,131(10): 861-870.
[8] Pasupathy S,Lindahl B,Litwin P,et al.Survival in patients with suspected myocardial infarction with nonobstructive coronary arteries: a comprehensive systematic review and meta-analysis from the MINOCA global collaboration[J].Circ Cardiovasc Qual Outcomes,2021,14(11):7880.
[9] Dreyer RP,Tavella R,Curtis JP,et al.Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population[J].Eur Heart,2020,41(7): 870-878.
[10] Choo EH,Chang K,Lee KY,et al.Prognosis and predictors of mortality in patients suffering myocardial infarction with non-obstructive coronary arteries[J].Am Heart Assoc,2019,8(14):11990.
[11] Quesada O,Yildiz M,Henry TD,et al.Mortality in ST-segment elevation myocardial infarction with nonobstructive coronary arteries and mimickers[J].JAMA Netw Open,2023,6(11):2343402.
[12] Kovach CP,Hebbe A,O'Donnell CI,et al.Comparison of patients with nonobstructive coronary artery disease with versus without myocardial infarction (from the VA clinical assessment reporting and tracking [CART] program)[J].Am Cardiol,2021(146): 1-7.
[13] Bossard M,Gao P,Boden W,et al.Antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease[J].Heart,2021,107(21): 1739-1747.
[14] Kim BK,Hong SJ,Cho YH,et al.Effect of ticagrelor monotherapy vs ticagrelor with aspirin on major bleeding and cardiovascular events in patients with acute coronary syndrome:the TICO randomized clinical trial[J].JAMA,2020,323(23): 2407-2416.
[15] Giacoppo D,Matsuda Y,Fovino LN,et al.Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs.prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials[J].Eur Heart,2021,42(4): 308-319.