The effects of ticagrelor and clopidogrel on inflammatory factors after emergent percutaneous coronary intervention plus thrombus aspiration in patients with acute myocardial infarction / 中国中西医结合急救杂志

ABSTRACT

Objective To compare the effects of ticagrelor and clopidogrel on levels of inflammatory factors after emergent percutaneous coronary intervention (PCI) combined with thrombus aspiration in patients with acute myocardial infarction (AMI). Methods Two hundreds and sixteen patients with AMI undertaking emergent PCI plus thrombus aspiration admitted to Cangzhou Central Hospital from April 2014 to April 2017 were enrolled, and they were randomly assigned into a ticagrelor group and a clopidogrel group, each group 108 cases. After admission, the clopidogrel group received 300 mg aspirin and 300 mg clopidogrel loading, after operation, aspirin 100 mg and clopidogrel 75 mg were given, once a day maintaining for 12 weeks; ticagrelor group after admission received 300 mg aspirin and 180 mg ticagrelor loading and after operation 100 mg aspirin (once per day) and 90 mg ticagrelor (twice per day) were given, maintaining for 12 weeks. Venous blood was taken immediately after admission and 24 hour and 1, 4, and 12 weeks after PCI plus thrombus aspiration, and the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and soluble CD40 ligand (sCD40L) were measured by double antibody enzyme linked immunosorbent assay (ELISA). Results Twenty-four hours after the operation, the levels of inflammatory factors, CRP, IL-6 and sCD40L were significantly higher than those before operation, the levels of the above inflammatory factors continued to decrease at the time points 1, 4, and 12 weeks later, reaching the lowest level at 12 weeks, and the above levels in ticagrelor group were significantly lower than those in clopidogrel group [CRP (μg/L) 2.96±0.63 vs. 4.44±0.34, IL-6 (ng/L) 2.50±0.51 vs. 2.81±0.21, sCD40L (ng/L) 519.60±12.53 vs. 570.25±11.55, all P < 0.05]. Conclusion The anti-inflammatory effect of ticagrelor is greater and more durable than that of clopidogrel after emergent PCI plus thrombus aspiration in patients with AMI.