ABSTRACT
OBJECTIVE:To compare clinical efficacy and safety of clopidogrel and ticaprelor in the treatment of acute non-ST elevation myocardial infarction (NSTEMI).METHODS:A total of 160 NSTEMI patients admited in cardiovascular disease department of our hospital during Oct.2013-Nov.2015 were divided into observation group and control group according to random number table,with 80 cases in each group.Both groups received routine treatment and continues intravenous pump of Tirofiban hydrochloride sodium chloride injection at 0.05 μg/(kg·h).Control group was additionally given oral loading-dose of Clopidogrel hydrogensultate tablet 300 mg,adjusted to 75 mg,qd,on the basis of routine treatment.Observation group was additionally given oral loading-dose of ticaprelor 180 mg,adjusted to 90 mg,bid,on the basis of routine treatment.Both groups received 1 month of treatment.The rate of platelet aggregation,LVEF,LVEDD,fibrinogen levels,the incidence of MACE and bleeding events were compared in 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in the rate of platelet aggregation between 2 groups (P＞0.05).After 1 week and 1 month of treatment,the rates of platelet aggregation in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After 1 week of treatment,there was no statistical significance in the levels of LVEF or LVEDD between 2 groups (P＞0.05).After 1 month of treatment,LVEF of observation group was significantly higher than that of control group,LVEDD was significantly lower than control group,with statistical significance (P＜0.05).There was no statistical significance in the level of fibrinogen before treatment and after 3 d of treatment (P＜0.05).After 1 week and 1 month of treatment,the levels of fibrinogen in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).The incidence of MACE in observation group was 11.25％,which was significantly lower than 25.00％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of bleeding (3.75％ vs.7.50％) between 2 groups (P＞0.05).CONCLUSIONS:Compared with clopidogrel,ticaprelor effectively inhibits platelet aggregation in NSETMI patients,reduces the level of fibrinogen,improves cardiac function and prognosis and doesn't increase the risk of bleeding with good safety.