Résumé
Objective:To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease (CHD) and hyperhomocysteinemia (Hhcy).Methods:A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention (PCI) were enrolled. They were divided into ticagrelor group ( n=49) and clopidogrel group ( n=52) according to the different antiplatelet drugs used. The clinical data of the two groups were collected, and the incidence of major cardiovascular and cerebrovascular adverse events (MACCE) and bleeding events in one year were compared between the two groups. Results:There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups ( P>0.05). Compared with clopidogrel group, ticagrelor can reduce the total MACCE (8.16% vs 32.69%, P<0.05) and the incidence of unstable angina pectoris events (0 vs 13.46%, P<0.05) in patients with hyperhomocysteinemia PCI 1 year after operation. The incidences of ischemic stroke, unstable angina pectoris, recurrent myocardial infarction, and cardiogenic death were compared separately between the two groups, and the difference was not statistically significant ( P>0.05). The incidence of major bleeding events, minor bleeding events, and minimal bleeding events were similar between the two groups, and the difference was not statistically significant (4.08% vs 0; 4.08% vs 1.92%; 20.41% vs 9.62%; P>0.05). Conclusions:In patients with CHD and Hhcy, ticagrelor can play a better antithrombotic effect, reduce the incidence of ischemic events, and has good security, which is more worthy of clinical recommendation.