PDF(Pubmed)
Abstract：
UNASSIGNED: Dual antiplatelet therapy is standard for patients undergoing percutaneous coronary intervention (PCI) with stents. Traditionally, patients swallow the loading dose of a P2Y12 inhibitor before or during PCI. Time to achieve adequate platelet inhibition after swallowing the loading dose varies significantly. Chewed tablets may allow more rapid inhibition of platelet aggregation. However, data for this strategy in patients with stable ischemic heart disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) are less robust.
UNASSIGNED: In this single-center prospective trial, 112 P2Y12-naïve patients with stable ischemic heart disease or NSTE-ACS on aspirin therapy and who received ticagrelor after coronary angiography but before PCI were randomized to chewing (n=55) or swallowing (n=57) the ticagrelor loading dose (180 mg). Baseline variables were compared using 2-sample t-test and chi-squared/Fisher\'s exact tests as appropriate, with alpha set at 0.05. P2Y12 reaction units (PRU) were compared at baseline, 1 hour, and 4 hours using Wilcoxon rank-sum test. Patients then received standard ticagrelor dosing.
UNASSIGNED: After exclusions, P2Y12 PRU in the chewed and swallowed groups at baseline, 1 hour, and 4 hours after ticagrelor loading dose were 243 vs 256 (P=0.75), 143 vs 210 (P=0.09), and 28 vs 25 (P=0.89), respectively. No differences were found in major adverse cardiac events (MACE) or major bleeding at 30 days and 1 year.
UNASSIGNED: In patients with stable ischemic heart disease or NSTE-ACS, chewing rather than swallowing ticagrelor may lead to slightly faster inhibition of platelet aggregation at 1 hour with no increase in MACE or major bleeding.
UNASSIGNED: In this single-center prospective trial, 112 P2Y12-naïve patients with stable ischemic heart disease or NSTE-ACS on aspirin therapy and who received ticagrelor after coronary angiography but before PCI were randomized to chewing (n=55) or swallowing (n=57) the ticagrelor loading dose (180 mg). Baseline variables were compared using 2-sample t-test and chi-squared/Fisher\'s exact tests as appropriate, with alpha set at 0.05. P2Y12 reaction units (PRU) were compared at baseline, 1 hour, and 4 hours using Wilcoxon rank-sum test. Patients then received standard ticagrelor dosing.
UNASSIGNED: After exclusions, P2Y12 PRU in the chewed and swallowed groups at baseline, 1 hour, and 4 hours after ticagrelor loading dose were 243 vs 256 (P=0.75), 143 vs 210 (P=0.09), and 28 vs 25 (P=0.89), respectively. No differences were found in major adverse cardiac events (MACE) or major bleeding at 30 days and 1 year.
UNASSIGNED: In patients with stable ischemic heart disease or NSTE-ACS, chewing rather than swallowing ticagrelor may lead to slightly faster inhibition of platelet aggregation at 1 hour with no increase in MACE or major bleeding.
摘要：
■双重抗血小板治疗是接受经皮冠状动脉介入（PCI）支架的患者的标准治疗。传统上,患者在PCI之前或期间吞服负荷剂量的P2Y12抑制剂.吞咽负荷剂量后达到足够血小板抑制的时间显著变化。咀嚼片剂可允许更快速地抑制血小板聚集。然而,在患有稳定性缺血性心脏病或非ST段抬高急性冠脉综合征(NSTE-ACS)的患者中,该策略的数据不太可靠.
■在这项单中心前瞻性试验中，112名接受阿司匹林治疗并在冠状动脉造影后但在PCI前接受替格瑞洛治疗的稳定性缺血性心脏病或NSTE-ACS的P2Y12初治患者被随机分为咀嚼(n=55)或吞咽(n=57)替格瑞洛负荷剂量(180mg)。基线变量使用2样本t检验和卡方/Fisher精确检验进行比较，alpha设置为0.05。P2Y12反应单位（PRU）在基线比较，1小时,和4小时使用Wilcoxon秩和检验。然后患者接受标准替格瑞洛给药。
■排除后，基线时咀嚼和吞咽组的P2Y12PRU，1小时,替格瑞洛负荷后4小时剂量为243比256（P=0.75），143vs210（P=0.09），和28vs25（P=0.89），分别。在30天和1年时，主要不良心脏事件（MACE）或大出血没有发现差异。
■在患有稳定性缺血性心脏病或NSTE-ACS的患者中，咀嚼而不是吞咽替格瑞洛可能导致1小时时血小板聚集的抑制略快,而MACE或大出血没有增加.
■在这项单中心前瞻性试验中，112名接受阿司匹林治疗并在冠状动脉造影后但在PCI前接受替格瑞洛治疗的稳定性缺血性心脏病或NSTE-ACS的P2Y12初治患者被随机分为咀嚼(n=55)或吞咽(n=57)替格瑞洛负荷剂量(180mg)。基线变量使用2样本t检验和卡方/Fisher精确检验进行比较，alpha设置为0.05。P2Y12反应单位（PRU）在基线比较，1小时,和4小时使用Wilcoxon秩和检验。然后患者接受标准替格瑞洛给药。
■排除后，基线时咀嚼和吞咽组的P2Y12PRU，1小时,替格瑞洛负荷后4小时剂量为243比256（P=0.75），143vs210（P=0.09），和28vs25（P=0.89），分别。在30天和1年时，主要不良心脏事件（MACE）或大出血没有发现差异。
■在患有稳定性缺血性心脏病或NSTE-ACS的患者中，咀嚼而不是吞咽替格瑞洛可能导致1小时时血小板聚集的抑制略快,而MACE或大出血没有增加.
