Résumé
Objective:To explore the efficacy and safety of ticagrelor versus clopidogrel in acute coronary syndrome (ACS) Chinese patients using glycoprotein Ⅱb/Ⅲa inhibitor (GPI).Methods:The data from CCC-ACS (Improving Care for Cardiovascular Disease in China-ACS) project were systematically reviewed in ACS patients with GPI. The patients were divided into ticagrelor and clopidogrel groups. A logistic analysis and propensity score matching (PSM) were performed to compare occurrences of major cardiovascular events (MACE) and bleeding events between the two groups during hospitalization.Results:A total of 63 641 ACS patients were collected from 150 hospitals. Logistic regression analyses showed that there was no statistically significant difference in the reduction of MACE between ticagrelor and clopidogrel when using GPI ( OR=0.881, 95% CI 0.599-1.296; P=0.521). However, major bleeding rate was higher in the ticagrelor group than that in the clopidogrel group ( OR=1.401, 95% CI 1.075-1.852; P=0.013). Similar results were observed after PSM. No statistic difference in MACE between the ticagrelor and clopidogrel group ( OR=0.919, 95% CI 0.613-1.376; P=0.681). Major bleeding rate was higher in the ticagrelor group ( OR=1.559, 95% CI 1.130-2.150; P=0.007). Conclusion:In ACS patients with GPI, ticagrelor did not reduce MACE, but increased the major bleeding risk compared with clopidogrel.
Résumé
Objective:To evaluate the clinical therapeutic effect and mechanism of recombinant human brain natri-uretic peptide (rhBNP,Xinhuosu)in patients with acute heart failure (AHF).Methods:A total of 90 AHF patients were randomly and equally divided into rhBNP group (received intravenous injection of rhBNP based on routine treatment for 3d)and routine treatment group.Left ventricular ejection fraction (LVEF),levels of serum high sen-sitive C reactive protein (hsCRP)and matrix metalloproteinase-9 (MMP-9)were measured and compared between two groups before and after treatment.Results:Compared with before treatment,after treatment,LVEF signifi-cantly rose,levels of hsCRP and MMP-9 significantly reduced in both groups,P <0.05 or <0.01;compared with routine treatment group after treatment,there was significant rise in LVEF [(41.4±12.8)% vs.(51.3±13.9)%], and significant reductions in levels of hsCRP [(8.63±3.57)mg/L vs.(6.67±3.97)mg/L]and MMP-9 [(17.89 ±4.75)mg/L vs.(14.64±4.89)mg/L]in rhBNP group,P <0.05 or <0.01. Conclusion:The rhBNP possesses significant therapeutic effect on acute heart failure,and its mechanism may be related with reducing hsCRP and MMP-9 levels.