| Objective:To explore the efficacy and safety of substitute clopidogrel for ticagrelor in the treatment of acute coronary syndrome. Methods:222cases of acute coronary syndrome patients were divided in two group, one is observation group, another is control group. Observation group to ticagrelor180-mg loading dose,90mg twice daily thereafter, for72hours after stop ticagrelor, substitute with300-mg loading dose of clopidogrel, then75mg daily thereafter. Control group to clopidogrel300-to-600-mg loading dose,75mg daily thereafter. All patients were followed7days and30days for main adverse cardiovascular and cerebrovascular events (MACCE)ã€Bleeding events and adverse events. Results:No significantly difference was noted in baseline between two groups. At7days, the primary end pointhad occurred in2.25%of patients receiving observation group as compared with9.02%of those receiving control group (hazard ratio,0.21;95%confidence interval[CI]0.051to1.062; P<0.05). Observation group of30days after the incidence of MACCE3.37%is lower than the control group10.11%(hazard ratio,0.32;95%confidence interval [CI]0.10to0.10; P<0.05).7days of observation group and control group bleeding eents compared respectively:8.99%and5.27%, P=0.515;10.11%and the incidence of bleeding is respectively:30days7.51%, P=0.51. There is no obvious difference incidence of adverse reactions in the two groups. Conclusions: Clopidogrel replacement for clopidogrel sequential treatment of acute coronary syndrome, its antiplatelet effect is not inferior to directly with clopidogrel, and does not increase the risk, of bleeding. In combination with the practical situation of China and the clinical characteristics of acute coronary syndrome, this study used method not only can achieve rapid antiplatelet aggregation, And long-term use of classic antiplatelet drugs. With China’s actual treatment of acute coronary syndrome has important guiding significance to the clinical application. |
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