Ticagrelor VS.clopidolgrel In Patients With Acute Coronary And Diabetes Undergoing Percutaneous Coronary Intervention Measured By Thrombelastography

Objective Thrombelastography for evaluating the antiplatelet efficacy and safety of clopidogrel and ticagrelor in the patients with ACS and Type2 diabetes mellitus undergoing PCI.Methods Eighty-seven patients with ACS and diabetes undergoing PCI were randomized into two groups.The patients of clopidolgrel group(n=43)preoperatively were given in loading aspirin 300 mg and clopidogrel 300 mg,followed by 100 mg aspirin and 75 mg clopidogrel per day.The patients of ticagrelor group(n=44) preoperatively were given in loading aspirin 300 mg and ticagrelor 180 mg followed by 100 mg aspirin per day and 90 mg ticagrelor twice one day. We investigated platelet reactivity(AA inhibition rate and ADP inhibition rate) by thrombelastography, and observed ischemic of cardiac and bleeding events over 3 mouths.Results The patients in ticagrelor group had low rate of MA-ADP pathway(%) compared with clopidogrel group [(34.94±11.91) % vs.(47.16±14.9)%,( P<0.001)].The inhibition rate in AA pathway(%) and inhibition rate in ADP pathway(%),tigcagrelor group superior to clopidogrel group [(68.24±22.96)% vs.(48.21±32.91)%,(58.16±23.52)% vs.(33.34±26.67)%,(p<0.001)].Conclusion Ticagrelor had more power to inhibit platelet reactivity,compared with clopidolgrel in patients with ACS and diabetes undergoing PCI.Ticagrelor when compared with clopidogrel,reduced ischaemic events during 3mouths,without increasing bleeding events.