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Analysis of thrombelastogram-guided medication in patients with coronary heart disease after percutaneous coronary

Yingbo Li1, Hongjin Chang2, Lina Ni1

  • 1Department of Clinical Laboratory, Weihai Central Hospital, Weihai, Shandong 264400, P.R. China.

Experimental and Therapeutic Medicine
|April 3, 2019
PubMed

Insights

Thrombelastogram-guided (TEG-guided) anti-platelet therapy using clopidogrel and aspirin significantly reduced major adverse cardiovascular events (MACE) and bleeding in patients undergoing percutaneous coronary intervention (PCI). TEG guidance offers more targeted treatment for coronary heart disease patients.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Trials
  • Pharmacology

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for coronary heart disease (CHD).
  • Anti-platelet therapy with clopidogrel and aspirin is standard post-PCI, but optimal dosing remains challenging.
  • Individualized anti-platelet response monitoring is crucial for effective and safe treatment.

Purpose of the Study:

  • To investigate the efficacy of thrombelastogram-guided (TEG-guided) clopidogrel and aspirin therapy.
  • To compare major adverse cardiovascular events (MACE) and bleeding rates between TEG-guided and standard therapy groups post-PCI.
  • To evaluate the impact of TEG guidance on coagulation function and platelet inhibition rates.

Main Methods:

  • Retrospective analysis of 203 patients undergoing PCI.
  • Comparison between an experimental group (104 patients) receiving TEG-guided anti-platelet therapy and a control group (99 patients) receiving standard therapy.
  • Evaluation of coagulation parameters (R, K, MA) and platelet inhibition rates.
  • Three-month follow-up for MACE and bleeding events.

Main Results:

  • The TEG-guided group showed significantly higher R and K values, and lower MA values post-treatment (P<0.05).
  • Higher postoperative platelet inhibition rates were observed in the TEG-guided group (P<0.05).
  • The incidence of MACE and bleeding events was significantly lower in the TEG-guided group compared to the control group (P<0.05).

Conclusions:

  • TEG-guided dose adjustment of clopidogrel and aspirin provides superior treatment outcomes for coronary heart disease patients post-PCI.
  • TEG guidance enables more targeted anti-platelet therapy, reducing MACE and bleeding risks.
  • Thrombelastogram guidance is a valuable and promotable tool for optimizing anti-platelet therapy in PCI patients.

Keywords:
aspirinclopidogrelcoronary heart diseasepercutaneous coronary interventionthrombelastogram

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