Comparative study of myocardial perfusion and prognosis in patients with acute myocardial infarction treated by ticagrelor or clopidogrel
10.3760/cma.j.issn.1673-4904.2019.02.011
- VernacularTitle:替格瑞洛与氯吡格雷对急性心肌梗死患者心肌灌注及预后的对比研究
- Author:
Juan ZHANG
1
;
Liangping ZHAO
;
Rongrong ZHANG
;
Xinyi ZHU
;
Haizhou SHU
;
Weiting XU
;
Jianchang CHEN
Author Information
1. 陕西省靖边县人民医院心内科 718500
- Keywords:
Coronary artery disease;
Ticagrelor;
Clopidogrel;
Myocardial perfusion
- From:
Chinese Journal of Postgraduates of Medicine
2019;42(2):139-143
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of ticagrelor and clopidogrel on platelet aggregation rate, myocardial perfusion and prognosis in patients with acute myocardial infarction. Methods One hundred and sixty-nine patients with acute ST segment elevation myocardial infarction (STEMI) and emergency percutaneous coronary intervention (PCI) were recruited and randomly divided into ticagrelor group (85 cases) and clopidogrel group (84 cases). The TIMI blood flow before and after PCI was recorded, and the ST segment fall rate of 1 h ECG after PCI was calculated. The platelet aggregation rate was measured. After 12 months' follow-up, the incidence of major adverse cardiac events (MACE) was recorded. The Logistic regression analysis was used to discover the factors of MACE. Results One hundred and sixty-nine patients with acute STEMI were recruited including 85 cases treated with ticagrelor and 84 cases in clopidogrel group. The ECG ST segment fall rate after PCI in ticagrelor group was significantly higher than that in clopidogrel group: (61.3 ± 30.7)％ vs. (47.8 ± 26.6)％, P<0.05. The platelet aggregation rate 2 h, 24 h and 7 d after PCI in ticagrelor group was significantly lower than that in clopidogrel group (P<0.05). MACE occurred in 19 cases (22.4％) in ticagrelor group and in 21 cases (25.0％) in clopidogrel group, and there was no significant difference (P > 0.05). Multiple Logistic regression analysis revealed that age and ECG ST segment fall rate were independent risk factors for MACE (P<0.05). Conclusions Compared with clopidogrel, ticagrelor can effectively reduce platelet aggregation rate and accelerate ST segment fall in STEMI patients, but their long-term prognosis is similar.
