ABSTRACT
Objective:To investigate the efficacy of ticagrelor combined with atorvastatin in the treatment of unstable angina pectoris and its effects on cardiac function, brain natriuretic peptide (BNP) level, lipoprotein-associated phospholipase A2 (Lp-PLA2) activity, and glycosylated hemoglobin (HbAlc) level in patients with unstable angina pectoris.Methods:A total of 200 patients with unstable angina pectoris who received treatment in the Sahzu International Medical Center from January 2017 to January 2019 were included in this study. These patients were randomly assigned to receive either clopidogrel combined with atorvastatin (control group, n = 100) or ticagrelor combined with atorvastatin (observation group, n = 100) for 1 month. The clinical efficacy,BNP level, Lp-PLA2 activity, HbAlc level, clinical symptom, cardiac function, and adverse reactions were compared between control and observation groups. Results:Effective rate was significantly higher in the observation group than in the control group [95% (95/100) vs. 75% (75/100), χ2 = 15.69, P < 0.001]. After treatment, BNP level and Lp-PLA2 activity in the observation group were (101.21 ± 40.13) ng/L and (105.56 ± 12.56) pg/L, respectively, which were significantly lower than those in the control group [(151.57 ± 37.29) ng/L, (137.52 ± 16.88) pg/L, t = 9.19, 15.19, P < 0.001]. After treatment, the duration and frequency of angina pectoris in the observation group were (1.84 ± 0.49) minutes/time and (1.32 ± 0.21) times/week, respectively, which were significantly lower than those in the control group [(5.23 ± 1.72) minutes/time and (3.58 ± 0.71) times/week, t = 18.95, 30.52, both P < 0.001]. After treatment, the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in the observation group were (33.28 ± 1.21) mm and (47.89 ± 5.61) mm respectively, which were significantly lower than those in the control group [(37.56 ± 2.14) mm, (53.25 ± 5.07) mm, t = 17.41, 7.09, both P < 0.001]. Left ventricular ejection fraction was significantly higher in the observation group than in the control group [(48.59 ± 5.81)% vs. (41.16 ± 5.83)%, t = 9.03, P < 0.001]. The incidence of adverse reactions was significantly higher in the observation group than in the control group [1% (1/100) vs. 12% (12/100), χ2 = 9.96, P = 0.002]. Conclusion:Ticagrelor combined with atorvastatin is highly effective for unstable angina pectoris in coronary heart disease because it greatly decreases BNP level and Lp-PLA2 activity. Therefore, the combined therapy deserves clinical promotion.
ABSTRACT
Objective@#To observe the clinical efficacy and safety of trimetazidine combined with ticagrelor in the treatment of unstable angina pectoris (UAP) complicated with chronic heart failure (CHF).@*Methods@#From January 2016 to September 2018, 60 UAP patients complicated with CHF in Taizhou Cancer Hospital were selected and randomly divided into two groups according to the random number table method, with 30 cases in each group.The control group was given ticagrelor, while the observation group was given ticagrelor + trimetazidine.The clinical efficacy, angina attack, cardiac function indicators, adverse reactions were compared between the two groups.@*Results@#The total effective rate of the observation group was 96.67%, which was higher than 80.00% of the control group (χ2=4.043, P<0.05). With in 3 months after treatment, the number of angina attacks (6.59±1.32)times and the duration of single angina pectoris [(2.24±0.92)min] in the observation group were all lower than those in the control group(t=4.277, 4.076, all P<0.05). After treatment, the left ventricular ejection fraction [(49.36±6.25)%] and stroke output [(76.29±5.31)mL] of the observation group were higher than those of the control group (t=4.066, 4.093, all P<0.05), and the level of brain natriuretic peptide [(378.32±27.82)μg/L] of the observation group was lower than that of the control group (t=4.152, P<0.05). The incidence rate of adverse reactions of the observation group was 6.67%, which of the control group was 3.33%, there was no statistically significant difference between the two groups (χ2=0.351, P>0.05).@*Conclusion@#The combination of ticagrelor and trimetazidine can effectively reduce the attack of angina pectoris, improve cardiac function and has less adverse reactions.It is effective and safe for UAP patients complicated with CHF.