Ticagrelor for patients with ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention

Abstract

Acute ST-segment elevation myocardial infarction (STEMI) is one of the most common cardiovascularemergencies. With the improvement of living standards, the incidence and mortality rate of STEMI hasshown a significant growth trend. Percutaneous coronary intervention (PCI) is the preferred choice forthe treatment of STEMI, and the rational use of antiplatelet drugs is an important factor for its success.Therefore, the correct use of antiplatelet agglutination drugs has become a widespread concern. In orderto evaluate the clinical efficacy of emergency PCI for patients with acute STEMI, 120 patients whounderwent emergency PCT in our hospital between January 2016 and December 2017 were randomlyselected and grouped into a clopidogrel group (clopidogrel + aspirin) and a ticagrelor group (ticagrelor+ aspirin) 60 per group. The thrombolysis in myocardial infarction (TIMI) flow grade of infarct relatedarteries, platelet aggregation rate and P2Y12 response unit before and after PCI and the major adversecardiovascular events (MACE), bleeding events and cardiac function after 30 days were compared betweenthe two groups. The results suggested that the proportion of the TIMI flow grade 3 of the ticagrelor groupwas significantly higher than the clopidogrel group after PCI, but the platelet aggregation rate and P2Y12response unit were significantly lower, and the differences had statistical significance (P<0.05). After 30days of follow up, it was found that the incidence of re-infarction and cardiac death, left ventricular enddiastolic diameter (LVEED) and left ventricular end systolic diameter (LVESD) of the ticagrelor groupwere significantly lower than those of the clopidogrel group, but the left ventricular ejection fraction(LVEF) of the ticagrelor was obviously higher; the differences had statistical significance (P<0.05). Noneof the patients had severe bleeding events, and the difference of the incidence of mild bleeding between thetwo groups had no statistical significance. Therefore, in conclusion, ticagrelor has better performance ininhibiting platelet than clopidogrel and better blood perfusion effect for STEMI patients who undergo PCIand it will not increase bleeding risks while improving the short-term prognosis.