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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Therapy with ticagrelor for ST-elevated acute coronary syndrome accompanied by diabetes mellitus

Y Liu1, L-Y Ding, X-Z Li

  • 1Department of Special Examination, Binzhou City Center Hospital, Binzhou, China. 285880332@qq.com.

European Review for Medical and Pharmacological Sciences
|August 8, 2019
PubMed

Insights

Ticagrelor improved myocardial microcirculation perfusion and cardiac function in ST-elevated acute coronary syndrome patients with diabetes mellitus. This study compared ticagrelor to clopidogrel, finding better perfusion with ticagrelor.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • ST-elevated acute coronary syndrome (STEMI) in patients with diabetes mellitus presents unique challenges.
  • Optimal antiplatelet therapy is crucial for improving outcomes in this high-risk population.

Purpose of the Study:

  • To evaluate the myocardial protective effects of ticagrelor compared to clopidogrel in patients with STEMI and diabetes mellitus.
  • To assess the impact on myocardial microcirculation, necrosis markers, and cardiac function.

Main Methods:

  • A randomized trial involving 210 patients with STEMI and diabetes mellitus undergoing percutaneous coronary intervention (PCI).
  • Patients were assigned to either ticagrelor or clopidogrel groups.
  • Myocardial microcirculation was assessed using ST-segment resolution (STR) and myocardial blush grade (MBG). Cardiac function and necrosis markers were also evaluated.

Main Results:

  • Ticagrelor group showed significantly lower levels of cardiac enzymes (CK, CK-MB, cTnI) and brain natriuretic peptide (BNP) compared to the clopidogrel group (p<0.05).
  • Myocardial microcirculation perfusion was significantly improved in the ticagrelor group, evidenced by higher STR and MBG rates (p<0.01).
  • The incidence of mild bleeding was higher in the ticagrelor group (p<0.05), while Thrombolysis in Myocardial Infarction (TIMI) flow and tirofiban usage showed no significant difference.

Conclusions:

  • Ticagrelor demonstrates superior efficacy in enhancing myocardial microcirculation perfusion in STEMI patients with diabetes mellitus.
  • Ticagrelor application improves left heart function and reduces myocardial necrosis markers compared to clopidogrel in this patient cohort.
Abstract

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