The Safety Profile of the Short-Term Combination Therapy of Ticagrelor With PPI or H2RA in Patients With Acute STEMI Underwent PCI

Abstract

Background: The combination therapy of anti-platelet medication and PPI/H2RA was recommended but yet being controversial due to the safety issue. To evaluate the efficacy and safety of the combination therapy of ticagrelor and PPI/H2RA on patients with acute STEMI receiving PCI. Methods: A total of 170 patients were hospitalized for PCI due to acute STEMI. The patients were divided into 4 groups receiving pantoprazole+ ticagrelor, omeprazole+ ticagrelor, ranitidine+ ticagrelor and ticagrelor only, respectively. The the prognosis of the therapy was evaluated and compared to verify the efficacy and safety of the combination therapy. Findings: No significant differences were found in IRA perfusion indexes (TIMI, CTFC), incidence of stent thrombosis after PCI, platelets indicators (PLT, MPV, PDW), platelets activation (P-selectin and GPIIb/IIIa levels), TEG indicators (ADP%, MAADP), myocardial necrosis biomarker (CK-MB, cTnI) and BNP levels between the 4 groups of patients after 7 days of follow-up. Patients receiving PPI+tecagrelor had significantly better safety profile than those who were given ticagrelor only. Interpretation: Based on our findings, the combinational application of tecagrelor and PPI yielded a satisfying safety profile in patients with acute STEMI after PCI. Funding Statement: None. Declaration of Interests: The authors declare that they had no competing interests. Ethics Approval Statement: This work was approved by the Ethics Committee of The First Affiliated Hospital with Nanjing Medical University. Written informed consent was obtained from all patients.