Influence of ticagrelor combined reteplase intravenous thrombolysis on serum RyR 2 and UCP2 levels and cardiac function in aged patients with acute STEMI／ / 心血管康复医学杂志

ABSTRACT

To study influence of ticagrelor combined reteplase (rPA) intravenous thrombolysis on serum levels of ryanodine receptor 2 (RyR2) and uncoupling protein 2 (UCP2) and cardiac function in aged patients with acute ST elevation myocardial infarction (STEMI ).Methods:A total of 92 STEMI patients treated in our hospital from Dec 2015 to Dec 2017 were selected .Patients were divided into ticagrelor group (n＝47) and clopidogrel group (n＝45) according to therapeutic method ,both groups received corresponding medication based on aspirin ,rPA and routine treatment for three months .Coronary recanalization rate on 30～120min after treatment ,serum levels of RyR2 ,UCP2 and cardiac function indexes before and after treatment ,adverse reaction were observed and compared between two groups .Results:As time went on ,coronary recanalization rate gradually rose in two groups , P＜0. 05 or ＜0. 01 ,but there was no significant difference between two groups , P＞ 0. 05 all.Compared with clopidogrel group after treatment ,there were significant rise in serum levels of RyR 2 [ (0.44 ± 0.08) μg／ml vs .(0. 48 ± 0. 09) μg／ml] ,UCP2 [(0. 40 ± 0. 09) μg／ml vs.(0. 45 ± 0. 08) μg／ml] ,LVEF [(58.56 ± 4. 05)% vs.(61. 95 ± 4. 63)%] and mitral early／late diastolic peak flow velocity [E／A ,(1.19 ± 0. 22) vs.(1.30 ± 0. 24)] ,and significant reduc‐tions in LVESd [(51.95 ± 8.64) mm vs.(47.32 ± 6.49) mm] ,LVEDd [(62.36 ± 9.71) mm vs.(56.72 ± 10. 43) mm] ,incidence rate of cardiovascular events (22.22% vs.6. 38%) ,mean hospital stay [ (5.63 ± 1.04) d vs.(4. 92 ± 0.87) d] and incidence rate of hemorrhage (28.89% vs .10. 64%) in ticagrelor group , P＜0.05 or ＜0.01. Con‐clusionTicagrelor combined rPA intravenous thrombolysis possesses high coronary recanalization rate in aged STE‐MI patients .It can significantly improve cardiac function and reduce incidence of cardiovascular events and hemor‐rhage .