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Published on: May 28, 2019
[Midterm follow-up outcomes of ticagrelor on acute ST segment elevation myocardial infarction undergoing emergency
Jing-gang Xia1, Yang Qu2, Shao-dong Hu1
1Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Insights
Ticagrelor demonstrated superior efficacy in reducing major adverse cardiovascular events for acute ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention compared to clopidogrel, with similar safety profiles.
Area of Science:
- Cardiology
- Pharmacology
- Interventional Cardiology
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular emergency.
- Primary percutaneous coronary intervention (PCI) is the standard reperfusion therapy for STEMI.
- Effective antiplatelet therapy is crucial for preventing thrombotic events post-PCI.
Purpose of the Study:
- To compare the efficacy and safety of ticagrelor versus clopidogrel in STEMI patients undergoing primary PCI.
- To evaluate the impact of ticagrelor on platelet inhibition and clinical outcomes.
Main Methods:
- A randomized controlled trial involving 96 STEMI patients undergoing primary PCI.
- Patients were assigned to receive either ticagrelor or clopidogrel pre- and post-procedure.
- Key outcomes included adenosine diphosphate (ADP)-induced platelet inhibition, major adverse cardiovascular events (MACE), and bleeding complications over a 6-month follow-up.
Main Results:
- Ticagrelor significantly increased ADP-induced platelet inhibition compared to clopidogrel (80.2% vs. 75.3%, P<0.05).
- Ticagrelor group experienced fewer MACE (2 vs. 8 events, P<0.05) over 6 months.
- Bleeding complication rates were similar between the ticagrelor and clopidogrel groups (7 vs. 3 cases, P>0.05).
Conclusions:
- Ticagrelor is effective and safe for STEMI patients undergoing primary PCI.
- Ticagrelor offers improved prevention of thrombotic events compared to clopidogrel in this patient population.
- The enhanced platelet inhibition by ticagrelor translates to better clinical outcomes without increasing bleeding risk.
Objective:
To evaluate the safety and efficacy of antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Methods:
In the study, 96 patients suffering from acute ST segment elevation myocardial infarction onset within 12 h undergoing primary percutaneous coronary intervention from May to October in 2013 were randomly divided into ticagrelor group (n=48) and clopidogrel group (n=48) by using the method of random number table. Ticagrelor and clopidogrel antiplatelet treatment were used before and after operation. Their baseline data, coronary artery disease characteristics, platelet count, adenosine diphosphate(ADP)-induced platelet inhibition rate by thrombelastograph after 5 days of treatment, the major adverse cardiovascular events of the follow up for 6 months and bleeding complications were observed and compared in the two groups.
Results:
The differences between the two groups of patients with their baseline data, the features of coronary artery lesions, platelet count before and after 5 days of treatment had no statistical significance (P>0.05). ADP induced platelet inhibition rate [(80.2±10.7)%] after 5 days of treatment in ticagrelor group was significantly higher than that in clopidogrel group [(75.3±12.1)%, P<0.05]. The two groups of patients were followed up for 6 months, 8 cases of major adverse cardiovascular events occurred in clopidogrel group, 2 cases of major adverse cardiovascular events occurred in ticagrelor group, and there was significant difference between the two groups (P<0.05). The two groups (7 cases of 48 patients in ticagrelor group vs. 3 cases of 48 patients in clopidogrel group) had no statistically significant difference in bleeding complications (P>0.05).
Conclusion:
Antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing emergency PCI has good efficacy and safety.
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