ABSTRACT
Objective To compare effect of ticagrelor and clopidogrel on bleeding in elderly patients after stenting.Methods 48 elderly patients after stenting who were diagnosed with acute coronary syndrome in the hospital were collected.All patients were divided into clopidogrel group and ticagrelor group according to different therapy, 24 cases in each group,and were given corresponding drug treatment in each group.After treatment, the platelet inhibition rate, cardiovascular events and bleeding events were observed.Results After treatment, compared with clopidogrel group, the platelet inhibition rate was higher in ticagrelor group(P<0.05), the incidence of cardiovascular events was lower in ticagrelor group (4.16%vs.25.00%;P<0.05), but there was no obvious difference in incidence of bleeding events of ticagrelor group (4.16% vs.8.32%).Conclusion In elderly patients after stent implantation, ticagrelor could inhibit platelet aggregation better than clopidogrel, prevent the occurrence of cardiovascular events, and would not increase the risk of bleeding.
ABSTRACT
Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)
