Dual antiplatelet therapy with aspirin and clopidogrel for type B aortic dissection patients: Cardiac and inflammatory benefits with bleeding risks

Background: In recent years, the incidence of type B aortic dissection (TBAD) has shown an upward trend. Objective: This study investigated the impact of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel on TBAD, providing valuable insights for clinical management. Methods: A total of 120 TBAD patients admitted to our hospital between January 2022 and December 2023 were enrolled and randomized into two groups: A control group receiving standard treatment without DAPT and a research group receiving DAPT. Recovery time was measured in both groups. Cardiac function, coagulation parameters, inflammatory markers (interleukin [IL]-1?, IL-6, IL-10, tumor necrosis factor [TNF]-?, and systemic immune-inflammation index [SII]), and oxidative stress indicators (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], and malondialdehyde [MDA]) were assessed before and after treatment. Additionally, pain levels and adverse events, including bleeding and thrombotic risks, were monitored throughout the treatment period. Results: DAPT significantly shortens postoperative recovery time compared to aspirin monotherapy, highlighting its potential benefits in TBAD treatment. After treatment, analysis revealed more significantly improved cardiac and coagulation functions in the research group. Furthermore, compared with the control group, the research group had significantly lower levels of inflammatory factors and stress response and significantly higher levels of anti-inflammatory factors and antioxidant factors (P<0.05). During the short-term follow-up, the research group showed more pronounced pain relief and a reduced risk of thrombosis, albeit with an increased risk of bleeding. Conclusion: DAPT with aspirin and clopidogrel is more conducive to enhancing postoperative cardiac and coagulation functions and reducing inflammation in TBAD patients.