Comparison of the Effects of Clopidogrel and Tigrine on Arrhythmia Induced by PCI in Patients with Acute Coronary Syndromes / 医学研究杂志

ABSTRACT

Objective To investigate the effect of clopidogrel and tigrine on arrhythmia induced by percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS).Methods A total of 224 patients with PCI were selected as the study subjects.The patients were randomly divided into Tegrella group (n =112) and clopidogrel group (n =112).On the basis of 100mg/d aspirin after PCI,Ticagrelor group was given loading dose of 180mg and maintenance dose of 90mg/d,2 times for one day.And Clopidogrel group was given loading dose of 300mg and maintenance dose of 75mg/d,once one day.All patients were followed up for 1 year.The two groups were monitored by twelve lead Holter in 24 hours in 1,6 and 12 months after PCI.The arrhythmia-related adverse events were recorded in both groups.Results There were no significant changes in heart rate (HR),left ventricular ejection fraction (LVEF),left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in both groups (P ＞ 0.05).After 12 months,HR and LVEF were significantly decreased,LVESD and LVEDD were significantly increased in the Tegrella group,compared with clopidogrel group,the difference was statistically significant (P ＜ 0.05,P ＜ 0.01).There was no significant differences in the incidence of asymptomatic tachyarrhythmias,chronic arrhythmia and the total arrhythmia between the two groups at 1,6 and 12 months after operation (P ＞ 0.05).At the same time,there was also no significant changes in atrial premature beats and ventricular premature beats in both groups (P ＞ 0.05).In addition,after 12 months of PCI,11 cases (9.82％) stopped in the tegrine group was significantly higher than that in the clopidogrel group (7.25％) (P ＜0.01).In the two groups,the incidence of ≥ 4 arrest,multiple arrest and daytime arrest were higher than the incidence of 2-4s arrest,arrest once and nocturnal arrest.In 12 months after PCI,the above differences were statistically significant (P ＜ 0.01).Conclusion In patients with anti-platelet therapy after PCI,the incidence of asymptomatic arrhythmia adverse events caused by tigrolil is mainly due to arrest,the incidence is significantly higher than clopidogrel,and antiarrhythmic drugs may be given if necessary.