Therapeutic effect of ticagrelor on patients with clopidogrel resistant acute coronary syndrome / 心血管康复医学杂志

ABSTRACT

Objective: To study therapeutic effect of ticagrelor on patients with clopidogrel resistant acute coronary syndrome (CPGR‐ACS).Methods:A total of 138 patients underwent PCI and suffered CPGR‐ACS after PCI in our hospital were selected .Patients were randomly and equally divided into routine treatment group (received intensive therapy of clopidogrel + aspirin) and ticagrelor group (received ticagrelor + aspirin) ,both groups were treated for 90d .Platelet inhibition rate (PIR) ,serum levels of matrix metalloproteinase (MMP)‐2 andhsCRP ,heart rate vari‐ability (HRV) before and after treatment ,incidence of major adverse cardiovascular events (MACE) and hemor‐rhage were observed and compared between two groups .Results:After treatment ,compared with routine treatment group ,there was significant rise in PIR [ (25. 76 ± 4.63)% vs.(43.97 ± 6.43)%] ,and significant reductions in ser‐um levels of MMP‐2 [(44.85 ± 4. 51) ng／mlvs.(36.96 ± 3.72) ng／ml] and hsCRP [(11.64 ± 1. 2) mg／L vs.(7. 15 ± 0. 72) mg／L] ;significant rise in SDNN [ (62. 87 ± 6.33) msvs.(96.86 ± 9. 72) ms] , SDANN [ (37. 62 ± 3. 81) msvs.(46.38 ± 4.72) ms] , rMSSD [ (25. 70 ± 2.61) ms vs.(38.27 ± 3.93 ) ms] , PNN50 [ (3. 61 ± 0.37)% vs. (4. 93 ± 0. 51)%] and HF [ (163. 27 ± 16. 42 ) ms2 vs.(178. 68 ± 18.21 ) ms2 ] , and significant reduction in LF [ (283. 62 ± 28. 90) ms2 vs.(197.32 ± 20.18) ms2 ] in ticagrelor group , P＝0.001 all.Incidence rate of MACE in ti‐cagrelor group was significantly lower than that of routine treatment group (2. 90% vs.15.94%, P＝0. 009).There was no significant difference in incidence rate of hemorrhage events between two groups , P＝ 0.229. Conclusion:Ticagrelor possesses significant therapeutic effect on patients with clopidogrel resistant acute coronary syndrome , and it＇s safe .