Clinical observation of ticagrelor in patients with acute ST-segment elevation myocardial infarction before primary percutaneous coronary intervention

Abstract

Objective To observe the clinical effect of ticagrelor(ADP receptor antagonist) in patients with acute ST-segment elevation myocardial infarction(STEMI) before primary percutaneous coronary intervention(PCI). Methods Eighty patients with acute STEMI diagnosed by emergency centre were treated by primary PCI, and randomly divided into ticagrelor group and control group, with 40 cases in each group. TIMI grade flow of infarct-related artery (IRA) before and after PCI was assessed. The resolution of the sum of ST-segment elevation at 2 hours after PCI was observed. The left ventricular ejection fraction (LVEF) by Ultrasonic cardiogram 1 week after PCI was examined. The incidences of the bleeding complications and thrombocytopenia during hospitalization were recorded. The major adverse cardial events 1 month after PCI were followed-up. Results TIMI grade 0-1 flow of IRA in control group at initial angiography before PCI was significantly higher than that in ticagrelor group(85.0% vs 75.0%, P 0.05). TIMI grade 3 flow in ticagrelor group was higher than that in control group after PCI (95.0% vs 90.0%, P 0.05). There was more frequently complete STR in ticagrelor group than that in control group(80.0% vs 65.0%, P 0.05). The incidence of MACE in control group was higher than that in ticagrelor group, but there was no significant difference(P>0.05). Conclusions Administration of ticagrelor before primary PCI on patients with acute STEMI can make better the myocardial reperfusion, retrieve the moribund myocardium, recover survival function, improve the heart function. It does not increase the hemorrhage rate and the incidence of MACE, it is safe and effective. Key words: Myocardial infarction; Percutaneous coronary intervention; Ticagrelor; Clopidogrel