ABSTRACT
Objective:To compare the effects of different doses of ticagrelor on microcirculation, inflammatory factors and cardiac function in older adult patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 250 older adult patients with coronary heart disease who received PCI in The First People's Hospital of Wenling, China between March 2019 and March 2020 were included in this study. They were randomly assigned into group A and group B, with 125 patients per group. The group A was subjected to staged exercise and oral ticagrelor (45 mg once, twice a day). The group B was given staged exercise and oral ticagrelor (90 mg once, twice a day). Platelet function (maximum platelet aggregation rate, P2Y12 reaction unit), microcirculation (the index of microcirculatory resistance, circulatory flow reserve), inflammatory factor levels (high-sensitivity C-reactive protein, tumor necrosis factor alpha, interleukin-6), cardiac function recovery (left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption), cardiovascular adverse events, and bleeding events were compared between the two groups.Results:After treatment, maximum platelet aggregation rate and P2Y12 reaction unit in group B were (28.79 ± 3.52)% and (132.36 ± 12.16) U, respectively, which were significantly lower than those in group A [(33.45 ± 4.60)%, (146.79 ± 13.52) U, t = 8.99, 8.87, both P < 0.001]. After treatment, the index of microcirculatory resistance in group B was significantly lower than that in group A [(26.43 ± 4.51) vs. (29.68 ± 5.14), t = 5.31, P < 0.001]. Circulatory flow reserve in group B was significantly higher than that in group A [(2.16 ± 0.62) vs. (1.61 ± 0.50), t = 7.72, P < 0.001]. After treatment, tumor necrosis factor alpha, interleukin-6 and high-sensitivity C-reactive protein in group B were (39.54 ± 6.74) ng/L, (19.68 ± 4.06) ng/L, (5.98 ± 1.35) mg/L, respectively, which were significantly higher than those in group A [(28.26 ± 6.15) ng/L, (15.33 ± 3.87) ng/L, (4.83 ± 1.28) mg/L, t = 13.82, 8.67, 6.91, all P < 0.001]. After treatment, left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption in group B were (37.39 ± 5.10)%, (443.28 ± 29.64) m, (19.69 ± 3.57) L/min, respectively, which were significantly higher than those in group A [(34.64 ± 4.86)%, (410.45 ± 25.76) m, (17.33 ± 3.27) L/min, t = 4.36, 9.34, 5.45, all P < 0.001]. There was no significant difference in total incidence of cardiovascular events between the two groups (χ 2 = 0.05, P > 0.05). The incidence of bleeding events in group A was significantly lower than that in group B (4.80% vs. 13.60%, χ 2 = 5.79, P < 0.05). Conclusion:Compared with ticagrelor 90 mg/d, ticagrelor 180 mg/d can more greatly improve platelet function and microcirculation, reduce inflammatory reaction, promote the recovery of cardiac function, and reduce bleeding events in older adult patients with coronary heart disease after percutaneous coronary intervention.
ABSTRACT
Objective To observe and explore the effectiveness of irbesartan hydrochlorothiazide(IH) combine with Bisoprol‐ol fumarate(BIS) on youth hypertension .Methods Randomly divided 96 patients in our hospital from September 2012 to February 2015 into observation group and control group(48 cases in each/group) .the IH treatment was given to the control group based on regular drug ,while the BIS was given to the observation group on the basis of the control group .systolic pressure(SBP) ,diastic pressure(DBP) and heart rate(HR) ,left ventricular end diastolic diameter(LVEDD) ,E peak and left ventricular ejection fraction (LVEF) in the two groups before and after treatment were detected ,and comprehensive efficacy were evaluated based on blood pressure improvement .Results Before treatment ,the difference of SBP ,DBP ,HR ,LVEDD ,E peak and LVEF between the two groups was not statistically significant (P>0 .05);after treatment ,SBP ,DBP and HR were (116 .4 ± 11 .8)mm Hg ,(85 .3 ± 6 .7) mm Hg and (65 .2 ± 7 .1)times/min in the observation group ,respectively ,while in the control group ,SBP ,DBP and HR were (132 .8 ± 14 .6)mm Hg ,(96 .3 ± 6 .2)mm Hg and (75 .2 ± 8 .1)times/min ,respectively ,the difference was statistically significant(P<0 .05);after treatment ,LVEDD in observation group was significantly lower than the control group ,while LVEF ,E peak were significantly higher(P< 0 .05);the total effective rate in observation group was 95 .8% (46/48) ,while total effective rate was 75 .0% (36/48) in the control group ,the difference was statistically significant(P<0 .05) .Conclusion IH combined with BIS can significantly improve blood pressure in patients with juvenile hypertension and has significant effect ,thus it is a safe and effective therapy for juvenile hypertension .