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Influence of clopidogrel combined with aspirin on long-term prognosis and the therapeutic effects against stable angina pectoris in elderly patients |
TANG Wei, YAN Xiang, LIU Fang, SHEN Guilin |
Ward of Cadres, General Hospital of Western Theater Command,Chengdu 610083,China |
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Abstract Objective To analyze the influence of clopidogrel combined with aspirin on the long-term prognosis and its therapeutic effects against stable angina pectoris in elderly patients. Methods One hundred and eighty elderly patients with stable angina pectoris were selected as the subjects. According to the patients’ wishes and admission sequence numbers, the patients were equally divided into the study group and the control group. Patients in both groups received routine symptomatic treatments. However, those in the control group were given oral aspirin enteric-coated tablets, while those in the study group were treated with oral aspirin enteric-coated tablets (100 mg per day)plus clopidogrel bisulfate tablets (75 mg per day). Both groups received three-month antiplatelet therapy. The prothrombin time (PT), activated partial thromboplastin time (APTT), platelet aggregation rate (PAR), left ventricular ejection fraction (LVEF), stroke volume (SV) and the plasma D-dimer (D-D), fibrinogen (FIB) levels before and after treatment were measured and compared between the two groups. The incidence of adverse reactions during treatment, that of cardiovascular events such as unstable angina pectoris, myocardial infarction, sudden cardiac death, and the survival time without cardiovascular events were also analyzed and compared between the two groups. Results After treatment, levels of PT, APTT, LVEF and SV were elevated in both groups, while levels of FAR, D-D and FIB were lower. The difference was statistically significant (P<0.05). Levels of PT, APTT, LVEF and SV in the study group were higher than those in the control group, but FAR, D-D and FIB levels were lower, and there was statistically significant difference between the two groups (P<0.05). However, there was no statistically significant difference in the incidence of adverse reactions between the two groups. During the follow-up, there was no significant difference in the incidence of cardiovascular events or the mean survival time without cardiovascular events between the two groups. Conclusions Compared with the use of aspirin alone, clopidogrel combined with aspirin used in the treatment of elderly patients with stable angina pectoris can significantly improve the antiplatelet therapeutic effect, reduce the activity of the coagulation system, improve myocardial function, and is safe, but the influence on the improvement of long-term prognosis needs to be further studied.
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Received: 10 March 2020
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