Comparison of efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization
10.3760/cma.j.cn114015-20220726-00679
- VernacularTitle:分站式杂交冠状动脉血运重建术后替格瑞洛和氯吡格雷抗血小板聚集疗效与安全性的比较
- Author:
Mei JIN
1
;
Qian WANG
;
Shuang GAO
;
Jingwen ZHAO
;
Xiaofeng CHEN
;
Youyu WANG
;
Qingbo QIAO
Author Information
1. 保定市第二中心医院心内2科，保定 072750
- Publication Type:Journal Article
- Keywords:
Myocardial revascularization;
Ticagrelor;
Aspirin;
Clopidogrel;
Platelet aggregation inhibitors;
2-staged hybrid technique
- From:
Adverse Drug Reactions Journal
2023;25(1):40-46
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization (HCR).Methods:A prospective randomized controlled trial was conducted. According to the postoperative antiplatelet therapy scheme, the patients with coronary artery multivessel disease who underwent 2-staged HCR operation in our hospital were divided into ticagrelor group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 90 mg orally twice daily for 1 year) and clopidogrel group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 75 mg orally once daily for 1 year). The general condition, platelet aggregation funtion [maximum platelet aggregation rate (MPAR) and P2Y12 reaction unit (PRU) ] at different time points before and after operation, and platelet inhibition rate [aspirin resistance (AA), ticagrelor or clopidogrel resistance (ADP)], major adverse cardiovascular events (MACE), bleeding events, and adverse reactions after operation were analyzed and compared between the 2 groups.Results:A total of 124 patients were enrolled in the study, 62 patients each in the ticagrelor group and clopidogrel group. There were no statistically significant differences in baseline data (gender, age, New York Heart Association cardiac function classification, concomitant diseases, etc.) between the 2 groups (all P>0.05). The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group and clopidogrel group were lower than those before operation [(50±9)%, (36±8)%, (29±6)% vs. (65±11)% and (59±10)%, (47±9)%, (38±7)% vs. (65±12)%, all P<0.001]. The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group[(50±9)% vs. (59±10)%, (36±8)% vs. (47±9)%, (29±6)% vs. (38±7)%, all P<0.001]. The PRUs at 24 h, 7 d, and 1 month after operation in the 2 groups were lower than those before operation (all P<0.001). The PRUs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group(all P<0.001). There was no significant difference in the incidence of AA 24 hours after operation between the 2 groups ( P>0.05); the inhibition rate of ADP in the ticagrelor group was higher than that in the clopidogrel group ( P<0.001). At the 24th month of follow-up, the incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (11.3% vs. 27.4%, P<0.05). At the 12th month of follow-up, there was no statistically significant difference in incidence of bleeding events between the 2 groups (3.2% vs. 8.1%, P>0.05) . There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (16.1% vs. 11.3%, P>0.05) . Conclusions:Compared with clopidogrel+aspirin regimen, ticagrelor+aspirin regimen is more effective in inhibiting platelet aggregation and reducing postoperative MACE after 2-staged HCR. Both antiplatelet aggregation regimens do not increase the risk of bleeding and have no serious adverse reactions. Both regimens have good safety.
