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Objective To study the effect and safety of ticagrelor on platelet in ＞75 years old patients undergoing PCI.Methods One hundred and twenty ＞75 years old patients with acute coronary syndrome undergoing PCI were randomly divided into observation group treated with aspirin+ticagrelor (n =60) and control group treated with aspirin+ clopidogrel (n =60).They were followed up for 1 year after PCI.The major adverse cardiovascular events (MACE),bleeding events,drug-related side effects and all-cause mortality were compared between the two groups.Results No instent thrombosis occurred in any patients,myocardial infarction occurred in 2 patients,angina pectoris occurred in 5 patients and 3 patients died in observation group after 1 year of PCI.Instent thrombosis occurred in 4 patients,myocardial infarction occurred in 3 patients,angina pectoris occurred in 6 patients,and 4 patients died in control group after 1 year of PCI.The incidence of instent thrombosis was significantly lower while that of mild dyspnea was significantly higher in observation group than in control group (0％ vs 6.7％,10.0％ vs 0％,P＜0.05).Conclusion Ticagrelor can effectively prevent instent thrombosis and does not increase the risk of bleeding in ＞75 years old patients after PCI.
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Objective To analyze the characteristics of atherosclerosis in elderly patients with isolated systolic hypertension (ISH) combined with low diastolic blood pressure and risk factors related to low diastolic blood pressure (DBP).Methods A total of 447 elderly patients with untreated ISH were divided into the low DBP (DBP＜70 mmHg, 1 mmHg=0.133 kPa) group (n=206) and the non-low DBP (DBP＞ 70 mmHg) group (n=241) according the DBP level.Clinical data including brachial-ankle pulse wave velocity (baPWV), carotid artery ultrasonography, blood lipids, blood glucose, plasma homocysteine were collected and determined.baPWV, carotid intimal-medial thickness (IMT) and the incidence of carotid plaques were compared between the two groups.Risk factors for low DBP were analyzed.Results There were no significant difference in systolic pressure levels between the low DBP group and the non-low DBP group [(160.8±10.1) mmHg vs.(161.1-±-10.9) mmHg, P＞0.05].Pulse pressure, baPWV levels, IMT and the incidence of carotid artery plaque were higher in the low DBP group than in the non-low DBP group [(98.4 ±11.7) vs.(77.4±12.0) mmHg, (1 785.3±175.0) vs.(1 436.5±114.4), (1.2±0.2) mm vs.(1.1±0.3)mm and 78.2％ (161/206) vs.67.2％ (162/241), each P＜0.05].Stepwise logistic analysis showed that age, gender (female) and diabetes were independent risk factors for low DBP (OR=1.62, 2.07, 1.38, all P＜0.05).Conclusions Atherosclerosis is more serious in elderly patents with ISH combined with low diastolic blood pressure than those without low DBP.Age, gender (female) and diabetes are independent risk factors for low DBP.