Abstract:Objective To investigate the therapeutic effect of ticagrelor and clopidogrel in patients with acute coronary syndrome(ACS).Methods Sixty-eight patients with ACS who were admitted to our department were enrolled in this study. All the patients were treated with percutaneous coronary intervention (PCI)before they were randomly divided into two groups: ticagrelor group and clopidogrel group(n=34 in each). After seven days, thrombelastography (TEG )was used to compare the platelet inhibition rate between the two groups.After two months of follow-up, the major adverse events were compared between the two groups.Results After seven days of treatment, the platelet inhibition rate induced by ADP in ticagrelor group increased significantly(76.15±12.88)% vs (51.08±8.32)% compared with clopidogrel group.After two months of follow-up, there was one case of acute myocardial infarction, one death due to cardiovascular diseases and one case of gastrointestinal bleeding in clopidogrel group. One patient in ticagrelor group had medication suspended because of serious dyspnea.Conclusions For ACS patients who have received PCI, ticagrelor has a better anti platelet aggregation effect than clopidogrel, and it has proved to be safe.
李晓红, 杨明, 韩凌, 陈欣, 陈萍, 胡文泽. 替格瑞洛及氯吡格雷对急性冠脉综合征介入治疗后的疗效比较[J]. 武警医学, 2018, 29(1): 14-16.
LI Xiaohong, YANG Ming, HAN Ling, CHEN Xin, CHEN Ping, and HU Wenze. Comparison of antiplatelet effects of ticagrelor and clopidogrel in patients with acute coronary syndrome. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(1): 14-16.
Gurbel P A, Antonino M J, Tantry U S. Recent developments in clopidogrel pharmacology and their felation to clinical outcomes[J].Expert Opin Drug Metab Toxiclo,2009,5(8);989-1004.
[3]
James S,Akerblom A, Cannon C P, et al . Comparison of ticagrelor,the first reversible oral P2Y12receptor antagonist,with clopidogrel in patients with acute coronary syndromes:Rationale,design,and baseline characteristics of the PLATelet inhibition and patient Outcomes ( PLATO) trial[J].Am Heart J,2009,157: 599-605.
[4]
Sangu P V,Ranasinghe I, Aliprandi C B, et al . Trends and predictors of rehospitatlisation following an acute coronary syndrome: report from the Australian and New Zealand population of the Global Registry of Acute Coronary Events(GRACE) [J]. Heart, 2012, 98(23): 1 728-1731.
Bonaca M P,Bhatt D L,Cohen M, et al . Long-term use of ticagrelor in patients with prior myocardial infarction [J]. New Engl J Med,2015,372(19):1791-1800.
Storey R F,Becker R C,Harrington R A, et al .Characterization of dyspnoea in PLAT()study patients treated with ticagrelor or clopidogrel and its association with clinical outcomes[J].Eur Heart J,2011,32(23):2945-2953.
[13]
Belchikov Y G,Koenig S J, Dipasquale E M. Potential role of endogenous adenosine in ticagrelor-induced dyspnea [J].Pharmacotherapy,2013,33(8):882-887.