Article(id=1291707033699512352, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.22.002, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747929600000, receivedDateStr=2025-05-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896555590, onlineDateStr=2026-08-05, pubDate=1764259200000, pubDateStr=2025-11-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896555590, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896555590, creator=13701087609, updateTime=1785896555590, updator=13701087609, issue=Issue{id=1291707004800750583, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='22', pageStart='3151', pageEnd='3300', issueExtLink='null', onlineDate='null', pubDate='1764259200000', pubDateStr='2025-11-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896548700, creator='13701087609', updateTime=1785896693213, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291707610999316815, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291707610999316816, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3156, endPage=3163, ext={EN=ArticleExt(id=1291707034039250977, articleId=1291707033699512352, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical study of ticagrelor and clopidogrel combined with nicorandil respectively in elderly patients with angina pectoris after percutaneous coronary intervention for coronary heart disease, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To compare the efficacy and safety of ticagrelor combined with nicorandil versus clopidogrel combined with nicorandil in elderly coronary heart disease (CHD) patients experiencing angina pectoris following percutaneous coronary intervention (PCI).
Methods Patients with post-PCI angina admitted to our hospital were divided into treatment group and control group based on treatment protocols. The control group received clopidogrel bisulfate tablets (75 mg, qd), and nicotardil tablets (5 mg, tid) based on standard post-PCI therapy including aspirin enteric-coated tablets (100 mg, qd), atorvastatin calcium tablets (20 mg, qd). The treatment group received ticagrelor tablets (90 mg, bid), and nicotardil tablets (5 mg, tid) based on the same standard post-PCI therapy. Both groups underwent continuous treatment for 24 weeks. Sublingual nitroglycerin tablets were allowed for acute angina attacks. Primary outcomes included therapeutic efficacy, cardiac function indices, lipid profiles, lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, antiplatelet reactivity and coagulation parameters, Seattle angina questionnaire (SAQ) scores, and incidence of major adverse cardiovascular events (MACE) were compared between the two groups.
Results A total of 123 patients were enrolled with 59 patients in treatment group and 64 patients in control group. After treatment, the overall response rates in treatment group and control group were 91.53% (54 cases /59 cases) and 78.12% (50 cases/64 cases), respectively. Left ventricular end-diastolic diameter (LVEDD) in treatment group and control group were (44.76±4.23) mm and (46.63±4.13) mm, respectively; left ventricular end-systolic diameter (LVESD) were (30.16±4.22) and (32.57±5.13) mm, respectively; left ventricular ejection fraction (LVEF) were (61.49±6.24)% and (58.49±6.13)%, respectively; cardiac index (CI) were (2.80±0.29) and (2.67±0.27) L·min-1·m-2, respectively; triglycerides (TG) were (1.70±0.21) and (1.82±0.35) mmol·L-1, respectively; total cholesterol (TC) were (5.12±0.56) and (5.41±0.60) mmol·L-1, respectively; low-density lipoprotein cholesterol (LDL-C) were (3.28±0.64) and (3.57±0.58) mmol·L-1, respectively; high-density lipoprotein cholesterol (HDL-C) were (2.74±0.54) and (2.53±0.51) mmol·L-1, respectively; Lp-PLA2 were (231.63±32.47) and (244.89±35.62) ng·mL-1, respectively. Regarding antiplatelet and coagulation parameters, the arachidonic acid inhibition rate (AA-IR) in treatment group and control group were (81.26±15.11)% and (74.52±15.13)%, respectively; adenosine diphosphate inhibition rate (ADP-IR) were (78.56±15.96)% and (70.95±14.57)%, respectively; lower maximum platelet aggregation rate (MPAR) were (26.78±4.82)% and (28.52±4.18)%, respectively; coagulation rate (CR) were (18.04±2.04) and (19.28±2.71) sig·min-1, respectively; SAQ scores were significantly higher in the treatment group across all dimensions: angina stability were (82.80±9.10) and (78.53±8.91) points, respectively; attack frequency were (80.17±12.24) and (75.63±10.22) points, respectively; physical activity limitation were (82.10±10.26) and (77.77±9.99) points, respectively; disease awareness were (74.49±11.25) and (69.13±10.96) points, respectively; and satisfaction were (83.41±10.35) and (78.56±11.49) points, respectively; the difference of the above indexes were all statistically significant (all P<0.05). The total incidence rates of MACE in treatment group and control group were 6.78% (4 cases/59 cases) and 20.31% (13 cases /64 cases), respectively, with statistically significant difference (P<0.05).
Conclusion Compared with clopidogrel combined with nicorandil, ticagrelor combined with nicorandil exhibits superior efficacy in treating angina pectoris after CHD-PCI in elderly patients, with significant improvements in cardiac function and angina symptoms, as well as favorable safety profiles.
, authors=Bao-ping JIANG, Fang-fang MA, authorsList=Bao-ping JIANG, Fang-fang MA, authorCompany=null, correspAuthors=Fang-fang MA, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291707034404155427, articleId=1291707033699512352, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=替格瑞洛与氯吡格雷分别联合尼可地尔用于冠心病经皮冠状动脉介入术术后心绞痛老年患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 比较替格瑞洛片与氯吡格雷片分别联合尼可地尔片用于冠心病经皮冠状动脉介入术（PCI）术后心绞痛老年患者的疗效及安全性。
方法 以本院收治的冠心病PCI术后心绞痛患者为研究对象，按照治疗方法分为对照组和试验组。对照组在PCI术后常规西药治疗基础上（包括阿司匹林肠溶片每次100 mg，qd，阿托伐他汀钙片每次20 mg，qd，）给予硫酸氢氯吡格雷片每次75 mg，qd，尼可地尔片每次5 mg，tid，口服治疗；试验组同样在PCI术后常规西药治疗方案基础上给予替格瑞洛片每次90 mg，bid，尼可地尔片每次5 mg，tid，口服治疗；两组患者均连续治疗24 w。若心绞痛发作时可舌下含服硝酸甘油片。比较两组治疗疗效、心功能指标、血脂和脂蛋白相关磷脂酶A2（Lp-PLA2）水平、抗血小板药物反应性和凝血速度、西雅图心绞痛量表（SAQ）评分和心血管不良事件（MACE）发生情况。
结果 共入组123例患者，其中对照组64例、试验组59例。治疗后，试验组和对照组的总有效率分别为91.53%（54例/59例）和78.12%（50例/64例），左室舒张末期内径（LVEDD）分别为（44.76±4.23）和（46.63±4.13）mm，左心室收缩末期内径（LVESD）分别为（30.16±4.22）和（32.57±5.13）mm，左心室射血分数（LVEF）分别为（61.49±6.24）%和（58.49±6.13）%，心脏指数（CI）分别为（2.80±0.29）和（2.67±0.27）L·min-1·m-2，甘油三脂（TG）分别为（1.70±0.21）和（1.82±0.35）mmol·L-1，总胆固醇（TC）分别为（5.12±0.56）和（5.41±0.60）mmol·L-1，低密度脂蛋白胆固醇（LDL-C）分别为（3.28±0.64）和（3.57±0.58）mmol·L-1，高密度脂蛋白胆固醇（HDL-C）分别为（2.74±0.54）和（2.53±0.51）mmol·L-1，Lp-PLA2分别为（231.63±32.47）和（244.89±35.62）ng·mL-1，花生四烯酸抑制率（AA-IR）分别为（81.26±15.11）%和（74.52±15.13）%，二磷酸腺苷抑制率（ADP-IR）分别为（78.56±15.96）%和（70.95±14.57）%，血小板聚集率（MPAR）分别为（26.78±4.82）%和（28.52±4.18）%，凝血速率（CR）分别为（18.04±2.04）和（19.28±2.71）sig·min-1，心绞痛稳定状态分别为（82.80±9.10）和（78.53±8.91）分，发作情况分别为（80.17±12.24）和（75.63±10.22）分，躯体活动受限程度分别为（82.10±10.26）和（77.77±9.99）分，疾病认识程度分别为（74.49±11.25）和（69.13±10.96）分，满意程度分别为（83.41±10.35）和（78.56±11.49）分，上述指标2组间比较，在统计学上差异均有统计学意义（均P<0.05）。试验组和对照组心血管不良事件总发生率分别为6.78%（4例/59例）和20.31%（13例/64例），在统计学上差异有统计学意义（P<0.05）。
结论 与氯吡格雷相比，替格瑞洛联合尼可地尔治疗冠心病PCI术后心绞痛疗效更为显著，可改善老年患者心功能情况，缓解患者心绞痛症状，且安全性较高。
, authors=姜宝平, 马方方, authorsList=姜宝平, 马方方, authorCompany=null, correspAuthors=马方方, authorNote=
姜宝平（1985-），男，主治医师，主要从事冠脉介入治疗学方面的工作
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