Effects of ticagrelor combined with aspirin on serum MPO level, APTT and incidence of upper gastrointestinal bleeding in patients with coronary heart disease

Abstract

Objective To study the clinical efficacy of ticagrelor combined with aspirin for patients with coronary heart disease, and to analyze the effect on serum myeloperoxidase (MPO), activated partial thromboplastin time (APTT), and incidence of upper gastrointestinal bleeding. Methods 149 patients with coronary heart disease admitted to our hospital from October, 2015 to July, 2017 were selected as the research subjects; according to the random number table method, they were divided into a study group (n=75) and a control group (n=74). The control group was treated with aspirin on the basis of routine treatment, while the study group was treated with ticagrelor tablets on the basis of the control group. The patients’ clinical biochemical indicators before and after the treatment were collected. The serum inflammatory related factors, coagulation function indicators, and adverse events were analyzed. Results There were no statistical differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups after the treatment (all P>0.05). The levels of total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL) were significantly lower and the level of high density lipoprotein (HDL) was significantly higher in the study group than in the control group [(3.49±0.66) mmol/L vs. (5.08±1.11) mmol/L, (0.62±0.19) mmol/L vs. (1.58±0.34) mmol/L, (1.57±0.34) mmol/L vs. (3.09±0.58) mmol/L, and (1.88±0.37) mmol/L vs. (1.09±0.22) mmol/L; all P<0.05)]. The levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and MPO were significantly lower in the study group than in the control group [(3.57±0.59)mg/L vs. (4.92±0.78) mg/L, (13.15±2.39) pg/ml vs. (21.38±4.06) pg/ml, (2.97±0.56) pg/ml (3.82±0.64) pg/ml, and (155.16±32.08) mg/L vs. (207.56±39.44) mg/L; all P<0.05)]. After the treatment, the prothrombin time (PT), APTT, and thrombin time (TT) were significantly higher and the fibrinogen (FIB) was significantly lower in the study group than in the control group [(15.76±2.43) s vs. (12.25±2.03) s, (37.82±5.26) s vs. (32.18±4.63) s, (16.87±2.57) s vs. (12.38±1.49) s. and (2.18±0.43) g/L and (3.29±0.67) g/L; all P<0.05]. The total effective rate was significantly higher and the incidence of adverse reactions was significantly lower in the study group than in the control group (93.33% vs. 78.38% and 5.33% vs. 17.57%, both P<0.05). Conclusion The clinical efficacy of ticagrelor combined with aspirin for patients with coronary heart disease is better than that of aspirin alone; it can effectively alleviate the abnormal blood pressure, blood lipid, and heart rate, inhibit the levels of inflammatory factors, improve the coagulation function, and reduce the incidence of adverse reactions. Key words: Coronary heart disease; Ticagrelor; Aspirin; Myeloperoxidase; Activated partial thromboplastin time