ABSTRACT
Objective To evaluate the efficacy and safety of combined use of ticagrelor and cilostazol for patients with acute coronary syndrome (ACS) complicated with upper digestive tract diseases following percutaneous coronary intervention ( PCI).Methods A total of 262 consecutive ACS patients complicated with upper digestive tract diseases followed-up for one-year after PCI were included in this study.The patients were allocated into control group (combined use of ticagrelor and aspirin , n＝184) and cilostazol group ( combined use of ticagrelor and cilostazol , n ＝78) for antiplatelet treatment.The basic characteristics of the patients , change of the treatment regimens , cardiovascular events and hemorrhagic events were compared between two groups .Results After one year of follow-up, 16.8%(31/184)patients in control group and 3.8%(3/78)in cilostazol group changed antiplatelet regimens (χ2＝8.200,P＝0.004).There was no statistical difference in use of statins and ACEI/ARB between two groups(P＞0.05).The rate of proton pump inhibitor use in control group was significantly higher than that in cilostazol group [82.1%(151/184) vs.52.6%(41/78), χ2＝24.35, P＝0.000].However, the dosage of β-blockers in cilostazol group was significantly higher than that in control group [(39.1 ±12.4) mg vs.(28.6 ±10.1) mg, t ＝7.174,P＝0.000].No statistical difference was found in total cardiovascular events between two groups [21.7%(40/184) vs.12.8%(10/78),χ2＝2.822,P＝0.121].The incidence of gastrointestinal hemorrhage in control group was significantly increased compared with cilostazol group [12.0%(22/184) vs.2.6%(2/78),χ2＝5.807,P ＝0.018], however, there was no significant difference in hemorrhagic events concerning the thrombolysis for myocardial infarction between two groups [17.4%(32/184) vs.9.0%(7/78), χ2＝3.063,P＝0.089].Conclusion Combined use of cilostazol and ticagrelor is effective and safe for ACS patients with gastrointestinal hemorrhage or a higher risk of hemorrhage .
ABSTRACT
AIM:To investigate the effects of grasp seed procyanidins(GSP) on homocysteine-induced proliferation and migration in vascular smooth muscle cells(VSMC) and related molecular mechanisms.METHODS: Cell count and -TdR assay were used for detecting cell proliferation and DNA synthesis,ELISA assay was used for detecting inflammatory response,DCFH-DA assay for examining the levels of reactive oxygen species(ROS),Western blotting for detecting protein expression.RESULTS: Homocysteine(0.1-1 mmol/L) increased VSMC proliferation and migration,and the levels of ROS were in a dose-dependent manner.The results of Western blotting showed that homocysteine significantly increased the expression of MCP-1,IL-6 and TNF-?.However,Compared with control group,in GSP(5-20 g/L) group,the increased VSMC proliferation,migration and the production of ROS and the expression of MCP-1,IL-6 and TNF-? mediated by homocysteine were markedly suppressed.EMSA showed that in GSP treatment group,the NF-?B activation was also almost completely inhibited.CONCLUSION: GSP inhibits homocysteine-induced VSMC proliferation,migration and inflammatory response through interfering with ROS dependent on NF-?B signal pathway.