CAJ | 학술논문

目的：观察替格瑞洛在急性冠脉综合征（ACS）患者中使用的安全性和有效性。方法从2011年11月到2015年5月间在国内6家心脏中心住院的ACS患者中筛选出观察期间至少给予一剂替格瑞洛治疗的患者共1970例，回顾性分析其临床基线资料、替格瑞洛及其他抗血小板药物用药情况及随访临床事件，应用Kaplan-Meier法估算2年时死亡、卒中和出血事件的发生率。结果入选患者的平均年龄为（61.2±11.2）岁。不稳定型心绞痛、非ST段抬高型心肌梗死和ST段抬高型心肌梗死所占比例分别为42.8%、20.6%和36.6%。接受替格瑞洛治疗的平均天数为（161.4±126.0） d，出院后随访0~784 d，中位数随访时间195（145，371） d。随访期内共发生死亡20例，卒中5例，出血29例，Kaplan-Meier法估算的2年死亡、卒中和出血事件的发生率分别为1.5%、0.2%和2.3%，2年的无事件生存率为96.1%。结论接受替格瑞洛治疗的中国ACS患者，其死亡、卒中及出血发生率均较低，初步提示替格瑞洛对于中国ACS患者安全和有效，需大样本随机对照研究进一步证实。
목적：관찰체격서락재급성관맥종합정（ACS）환자중사용적안전성화유효성。방법종2011년11월도2015년5월간재국내6가심장중심주원적ACS환자중사선출관찰기간지소급여일제체격서락치료적환자공1970례，회고성분석기림상기선자료、체격서락급기타항혈소판약물용약정황급수방림상사건，응용Kaplan-Meier법고산2년시사망、졸중화출혈사건적발생솔。결과입선환자적평균년령위（61.2±11.2）세。불은정형심교통、비ST단태고형심기경사화ST단태고형심기경사소점비례분별위42.8%、20.6%화36.6%。접수체격서락치료적평균천수위（161.4±126.0） d，출원후수방0~784 d，중위수수방시간195（145，371） d。수방기내공발생사망20례，졸중5례，출혈29례，Kaplan-Meier법고산적2년사망、졸중화출혈사건적발생솔분별위1.5%、0.2%화2.3%，2년적무사건생존솔위96.1%。결론접수체격서락치료적중국ACS환자，기사망、졸중급출혈발생솔균교저，초보제시체격서락대우중국ACS환자안전화유효，수대양본수궤대조연구진일보증실。
Objective To investigate the effectiveness and safety of ticagrelor in Chinese patients with acute coronary syndrome(ACS). Method ACS patients(n=1970) who received at least one dose of ticagrelor were chosen from Nov. 2011 to May. 2015. Baseline clinical characteristics, ticagrelor and other antiplatelet regimens and clinical events during follow up period were retrospectively analyzed. The estimated 2-year event rates of death, stroke and bleeding, as well as 2-year event-free survival rate were calculated with the Kaplan-Meier method. Results The mean age of all patients was (61.2±11.2) years. The proportion of unstable angina was 42.8%, non-ST segment elevation myocardial infarction was 20.6%and ST segment elevation myocardial infarctio was 36.6%. The average ticagrelor treatment time was (161.4±126.0) days. The patients were followed-up 0~784 days from discharge, with a median time of 195 (145,371) days. According to the Kaplan-Meier method, the estimated 2-year event rates of death, stroke and bleeding were 1.5%, 0.2% and 2.3%. The 2-year event-free survival rate was 96.1%. Conclusions Ticagrelor is associated with low rates of death, stroke and bleeding, suggesting a satisfied effectiveness and safety of ticagrelor in treating Chinese ACS patients. It needs further confirmation by large-scale randomized trials.