Safety and Necessity of Antiplatelet Therapy on Patients Underwent Endovascular Aortic Repair with Both Stanford Type B Aortic Dissection and Coronary Heart Disease

作     者：Rui-Xia He Lei Zhang Tie-Nan Zhou Wen-Jie Yuan Yan-Jie Liu Wen-Xia Fu Quan-Min Jing Hai-Wei Liu Xiao-Zeng Wang He Rui-Xia;Zhang Lei;Zhou Tie-Nan;Yuan Wen-Jie;Liu Yan-Jie;Fu Wen-Xia;Jing Quan-Min;Liu Hai-Wei;Wang Xiao-Zeng

作者机构：Department of Cardiology General Hospital of Shenyang Military Region Shenyang Liaoning 110016 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2017年第130卷第19期

页      面：2321-2325页

核心收录：

学科分类：0832[工学-食品科学与工程（可授工学、农学学位）] 083002[工学-环境工程] 0830[工学-环境科学与工程（可授工学、理学、农学学位）] 1002[医学-临床医学] 07[理学] 08[工学] 09[农学] 0903[农学-农业资源与环境] 083201[工学-食品科学] 0713[理学-生态学] 

基　　金：Medical Ethics Committee of General Hospital of Shenyang Military Region  China 

主　　题：Acute Coronary Syndrome: Antiplatelet AorticDissection Endovascular Aortic Repair 

摘      要：Background： Acute aortic dissection is known as the most dangerous aortic disease, with management and prognosis determined as the disruption of the medial layer provoked by intramural bleeding. The objective of this study was to evaluate the safety and necessity of antiplatelet therapy on patients with Stanford Type B aortic dissection （TBAD） who underwent endovascular aortic repair （EVAR）. Methods： The present study retrospectively analyzed 388 patients with TBAD who underwent EVAR and coronary angiography. The primary outcomes were hemorrhage, death, endoleak, recurrent dissection, myocardial infarction, and cerebral infarction in patients with and without aspirin antiplatelet therapy at 1 month and 12 months. Results： Of those 388 patients, 139 （35.8%） patients were treated with aspirin and 249 （64.2%） patients were not treated with aspirin. Patients in the aspirin group were elderly （57.0 ± 10.3 years vs. 52.5 ± 11.9 years, respectively, χ2 = 3.812, P 〈 0.001） and had more hypertension （92.1% vs. 83.9%, respectively, χ2 = 5.191, P = 0.023） and diabetes （7.2% vs. 2.8%, respectively, χ2 = 4.090, P = 0.043） than in the no-aspirin group. Twelve patients （aspirin group vs. no-aspirin group; 3.6% vs. 2.8%, respectively, χ2 = 0.184, P = 0.668） died at 1-month follow-up, while the number was 18 （4.6% vs. 5.0%, respectively, χ2 = 0.027, P = 0.870） at 12-month follow-up. Hemorrhage occurred in 1 patient （Bleeding Academic Research Consortium [BARC] Type 2） of the aspirin group, and 3 patients （1 BARC Type 2 and 2 BARC Type 5） in the no-aspirin group at 1-month follow-up （ χ2 = 0.005, P = 0.944）. New hemorrhage occurred in five patients in the no-aspirin group at 12-month follow-up. Three patients in the aspirin group while five patients in the no-aspirin group had recurrent dissection for endoleak at 1-month follow-up （2.3% vs. 2.2%, respectively, χ2 = 0.074, P = 0.816）. Four patients had new dissection in the no-aspirin group at 12-month follow-up （2.3% vs. 3.8%, respec