Efficacy and safety of preoperative Ticagrelor loading treatment in emergency percutaneous coronary intervention for acute ST-segment elevation myocardial infarction

Abstract

Objective To observe the safety and efficacy of preoperative Ticagrelor loading in emergency percutaneous coronary intervention(PCI)for acute ST-segment elevation myocardial infarction(STEMI). Methods A total of 213 patients with acute STEMI before undergoing emergency PCI were randomly divided into Ticagrelor group(n=105)receiving 180 mg Ticagrelor loading dose, then 90 mg twice daily and Clopidogrel group(n=108) receiving 600 mg of Clopidogrel, then 75 mg once daily.Emergency PCI postoperative coronary artery TIMI flow grade and the change of incidence of no reflow, platelet aggregation rate, incidence of bleeding events and the incidence of major adverse cardiovascular events(MACE)were compared between two groups. Results The rate of no-reflow was 7.6%(8 cases)in Ticagrelor group, and 16.7%(18 cases)in Clopidogrel group(χ2=3.26、P=0.030). Platelet aggregation rates at 1 h and 24 h after treatment were (55.6±4.3)% and(48.6±4.1)% respectively in Ticagrelor group, and (63.6±3.8)% and(57.6±3.6)% respectively in Clopidogrel group, which showed that platelet aggregation inhibition effect was better in Ticagrelor than in Clopidogrel(t=14.40、17.20, both P=0.001). Two groups had no major life-threatening bleeding events.Bleeding incidence had no statistically significant difference between two groups(χ2=0.14, P=0.710), and the incidence of cardiovascular adverse events showed no statistically significant difference(χ2=0.04, P=0.840)between the 2 groups. Conclusions Preoperativeticagrelor loading treatment in emergency PCI therapy for acute ST segment elevation myocardial infarction shows stronger antiplatelet aggregation function, significantly improve postoperative TIMI flow, and does not increase the incidence of bleeding events. Key words: Myocardial infarction; Angioplasty, transluminal, percutaneous coronary