阿司匹林联合氯吡格雷治疗不稳定型心绞痛的疗效观察

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Unstable angina pectoris (UAP) (n=112). Intervention: Aspirin plus clopidogrel (dual antiplatelet therapy) vs. Aspirin monotherapy (300 mg loading dose then 100 mg once daily) on top of standard therapy. Primary outcome: Total clinical effective rate (composite reduction in angina attack frequency, nitroglycerin consumption, and ECG ST-segment recovery at 12 weeks) (p=0.023).

Q: What does this research mean for the field?

Aspirin combined with clopidogrel significantly improves clinical efficacy, alleviates ischemic symptoms, and suppresses inflammatory markers compared to aspirin alone in patients with unstable angina pectoris, without significantly increasing adverse events. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

川 王

doi:10.37155/2717-5693-0702-18

January 1, 2026内科诊疗与进展Open Access

阿司匹林联合氯吡格雷治疗不稳定型心绞痛的疗效观察

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Key result

DAPT boosts clinical response ~16 percentage points over aspirin alone in unstable angina.

P=0.023
n=112

Why the study?

The efficacy and safety of dual antiplatelet therapy with aspirin and clopidogrel in hospitalized patients with unstable angina pectoris required further clinical evaluation.

Does dual antiplatelet therapy with aspirin and clopidogrel improve clinical efficacy, angina symptoms, ECG ischemia, and inflammatory/platelet biomarkers compared to aspirin monotherapy in hospitalized patients with unstable angina pectoris?

Key Points

To investigate the clinical efficacy, anti-inflammatory effects, and safety of combining aspirin with clopidogrel for the treatment of unstable angina pectoris.
Randomized 112 hospitalized patients with unstable angina pectoris into an observation group (n=56; routine therapy plus aspirin and clopidogrel) and a control group (n=56; routine therapy plus aspirin) for a 12-week treatment course.
Administered aspirin at a 300 mg initial loading dose followed by 100 mg daily to both groups, while the observation group also received clopidogrel at a 300 mg loading dose followed by 75 mg daily.
Evaluated angina attack frequency and duration, nitroglycerin usage, ST-segment depression on 12-lead electrocardiograms, hs-CRP, IL-6, ADP-induced platelet aggregation rate, and adverse events.
The total effective rate was significantly higher in the observation group than in the control group (91.07% [51/56] vs 75.00% [42/56], P=0.023).
Compared with the control group, the observation group showed lower angina attack frequency (1.2±0.5 vs 2.8±0.9 attacks/week, P<0.01), shorter attack duration (2.1±0.8 vs 4.3±1.2 min, P<0.01), reduced nitroglycerin use (0.8±0.3 vs 1.6±0.5 mg/week, P<0.01), and less ST-segment depression (0.9±0.3 vs 1.5±0.4 mm, P<0.01).
Post-treatment hs-CRP (3.2±1.1 vs 5.8±1.6 mg/L), IL-6 (12.4±3.6 vs 19.7±4.8 ng/L), and platelet aggregation rate (32.5±6.7% vs 48.3±8.2%) were significantly lower in the observation group (all P<0.01), with no significant difference in adverse events between groups (8.93% vs 5.36%, P=0.462).

Study Design

Type

RCT (n=112)

Randomization

Random number table method (1:1 allocation)

Multicenter

No

Structured PICO

Does dual antiplatelet therapy with aspirin and clopidogrel improve clinical efficacy, angina symptoms, ECG ischemia, and inflammatory/platelet biomarkers compared to aspirin monotherapy in hospitalized patients with unstable angina pectoris?

P

Population

112 hospitalized adults (aged 35-80 years, 44.6% female) with troponin-negative unstable angina pectoris and >=2 angina episodes per week at a single center in China, treated and followed for 12 weeks.

I

Intervention

Clopidogrel (300 mg loading dose, then 75 mg once daily) plus aspirin (300 mg chewed loading dose, then 100 mg once daily) added to standard therapy (isosorbide dinitrate sustained-release 20 mg bid, atorvastatin 20 mg qn, metoprolol sustained-release 47.5 mg qd, and subcutaneous enoxaparin 4000 U q12h for 5-7 days) for 12 weeks.

C

Comparator

Aspirin monotherapy (300 mg chewed loading dose, then 100 mg once daily) added to standard UAP therapy (isosorbide dinitrate sustained-release 20 mg bid, atorvastatin 20 mg qn, metoprolol sustained-release 47.5 mg qd, and subcutaneous enoxaparin 4000 U q12h for 5-7 days) for 12 weeks.

O

Outcome

Total clinical effective rate (composite of marked effectiveness and effectiveness based on ≥50% reduction in angina attack frequency and nitroglycerin dosage, and ≥0.05 mV improvement in ECG ST-segment depression, without progression to acute myocardial infarction) at 12 weeks.composite

Main Result

Absolute Event Rate: 91.07% vs 75%

p-value: p=0.023

In hospitalized patients with unstable angina, adding clopidogrel to aspirin for 12 weeks significantly improves symptom relief, ischemic ECG changes, and systemic inflammation (hs-CRP, IL-6) without significantly increasing bleeding risk compared to aspirin alone.

Limitations

Small sample size
Single-center study
No long-term major adverse cardiovascular event (MACE) endpoints tracked
Lack of coronary imaging (OCT or coronary angiography) to evaluate plaque progression
No CYP2C19 genotyping performed
Lack of long-term cardiovascular event (MACE) endpoints

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Implication

Supports dual antiplatelet therapy over aspirin alone for higher clinical efficacy in unstable angina; confirms and extends CURE trial findings.

Abstract

王川（中国人民解放军空军二十三厂）目的：探究阿司匹林联合氯吡格雷双联抗血小板对不稳定型心绞痛（UAP）的作用以及安全性。方法：选取112名住院UAP患者，随机分为观察组（56例，常规治疗+阿司匹林+氯吡格雷）及对照组（56例，常规治疗+ 阿司匹林），疗程12周。观察两组患者心绞痛发作次数、心电图、炎症指标（hs-CRP、IL-6）、血小板聚集率、总有效率以及不良事件发生情况。结果：治疗后观察组心绞痛发作次数、持续时间和硝酸甘油用量、ST段下降程度均明显少于对照组（P均 < 0.01）；总有效率为91.07%，而对照组为75.00%，有统计学意义（P = 0.023）；hs-CRP、IL-6和平板运动试验血小板聚集率也明显低于对照组（P均 < 0.01）；但两组间不良事件的发生率无显著性差异（8.93%vs5.36%，P = 0.462）。结论：双联抗血小板治疗能够更有效地改善UAP的症状、提高缺血性心电图恢复率、减少炎症反应和血小板活性，而且比单独使用阿司匹林更加安全有效。目的：探究阿司匹林联合氯吡格雷双联抗血小板对不稳定型心绞痛（UAP）的作用以及安全性。方法：选取112名住院UAP患者，随机分为观察组（56例，常规治疗+阿司匹林+氯吡格雷）及对照组（56例，常规治疗+ 阿司匹林），疗程12周。观察两组患者心绞痛发作次数、心电图、炎症指标（hs-CRP、IL-6）、血小板聚集率、总有效率以及不良事件发生情况。结果：治疗后观察组心绞痛发作次数、持续时间和硝酸甘油用量、ST段下降程度均明显少于对照组（P均 < 0.01）；总有效率为91.07%，而对照组为75.00%，有统计学意义（P = 0.023）；hs-CRP、IL-6和平板运动试验血小板聚集率也明显低于对照组（P均 < 0.01）；但两组间不良事件的发生率无显著性差异（8.93%vs5.36%，P = 0.462）。结论：双联抗血小板治疗能够更有效地改善UAP的症状、提高缺血性心电图恢复率、减少炎症反应和血小板活性，而且比单独使用阿司匹林更加安全有效。

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Cite This Study

川王 (2026) conducted an RCT in Unstable angina pectoris (UAP) (n=112). Aspirin plus clopidogrel (dual antiplatelet therapy) vs. Aspirin monotherapy (300 mg loading dose then 100 mg once daily) on top of standard therapy was evaluated on Total clinical effective rate (composite reduction in angina attack frequency, nitroglycerin consumption, and ECG ST-segment recovery at 12 weeks) (p=0.023).

synapsesocial.com/papers/6af3479cbdf2424ebd04f8b3 https://doi.org/10.37155/2717-5693-0702-18

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阿司匹林联合氯吡格雷治疗不稳定型心绞痛的疗效观察

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

阿司匹林联合氯吡格雷治疗不稳定型心绞痛的疗效观察

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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