A Study On The Treatment Of Ticagrelor And Clopidogrel In Patients With Coronary Heart Disease (thoracic Obstruction And Heartache) After PCI

Objective: Percutaneous coronary intervention for left main coronary artery(LMCA)lesions of coronary heart disease(chest obstruction and heart pain)Intervention(PCI)After regular administration of ticagrelor and clopidogrel for 1 year,the primary endpoint,secondary endpoint,safety endpoint and the occurrence of re-hospitalization were evaluated,and the clinical efficacy,safety and advantages of aspirin and ticagrelor dual antiplatelet therapy(DAPT)were evaluated,To provide a basis for the long-term treatment of left main disease by traditional Chinese medicine after PCI.Objectives and Methods: From September 2017 to January 2019,150 patients with LMCA lesions who met the diagnostic criteria and inclusion criteria of traditional Chinese and Western medicine were enrolled in the study and were treated with PCI in the Second Ward of Cardiovascular Medicine Department of the North War Zone General Hospital.They were randomly divided into the ticagrelor group and the clopidogrel group,with 75 patients in each group.Two groups of patients were given: aspirin + ticagrelor,aspirin + clopidogrel,1-year DAPT expiration,clopidogrel group lost to follow-up in 5 cases,ticagrelor group lost to follow-up in 10 cases,and finally completed the follow-up in 135 cases.Seventy patients in the clopidogrel group and 65 patients in the ticagrelor group were enrolled in the 1-year DAPT.Major adverse cardiovascular events(MACE),secondary endpoints,safety endpoints and re-hospitalization were compared between the two groups.Result:1.One year after DAPT treatment in patients with LMCA lesions after PCI,the difference in MACE between clopidogrel group and ticagrelor group was statistically significant(P < 0.05),while there was no significant difference in non-fatal acute myocardial infarction,ischemic stroke,in-stent restenosis or thrombosis,target vessel revascularization(re-PCI or CABG)(P > 0.05).Cardiac death occurred in 0 patients(0%)in both groups.2.The difference of secondary endpoints between the two groups was statistically significant(P < 0.05).The frequency of recurrent angina,severe arrhythmia(ventricular tachycardia,cardiac arrest)and heart failure in the ticagrelor group was lower than that in the clopidogrel group.3.There was no significant difference in safety endpoints between the two groups: BARC hemorrhage(BARC type 0,type 1-2,type 3-5)and TIMI hemorrhage(minor hemorrhage,minor hemorrhage,major hemorrhage)(P > 0.05).4.There was a significant difference in re-hospitalization due to angina between the two groups(P < 0.05),and the re-hospitalization rate due to angina in the ticagrelor group was lower than that in the clopidogrel group;there was no significant difference in re-hospitalization due to other reasons between the two groups(P > 0.05).5.There was a significant difference in the occurrence of secondary endpoint events between the two groups of patients with Qi-Yin Deficiency Syndrome(P < 0.05),and the frequency of secondary endpoint events was as follows: clopidogrel group > ticagrelor group;the occurrence of secondary endpoint events was compared between the two groups of qi deficiency and blood stasis syndrome,heart blood stasis syndrome,other syndromes(phlegm turbidity,qi stagnation and blood stasis syndrome,kidney yang deficiency and failure syndrome of heart-kidney Yin deficiency and cold coagulation and stasis syndrome).There was no significant difference in point events(P > 0.05).6.There was no significant difference in safety endpoints between the two groups of various TCM syndromes(P > 0.05);there was no significant difference in safety endpoints(BARC hemorrhage,TIMI hemorrhage)between the two groups of qi deficiency and blood stasis syndromes(P > 0.05).7.There was no significant difference in re-hospitalization due to angina between the two groups of qi deficiency and blood stasis syndrome(P > 0.05).Conclusion:1.In patients with LMCA lesions treated with DAPT for 1 year after PCI,the incidence of total MACE in the ticagrelor group was lower than that in the clopidogrel group;there was no difference in the primary endpoint classification between the two groups.The incidence of recurrent angina,severe arrhythmias(ventricular tachycardia,cardiac arrest)and heart failure in the ticagrelor group was lower than that in the clopidogrel group.2.There was no difference in safety endpoints between the two groups.The re-hospitalization rate for angina pectoris was lower in the ticagrelor group than in the clopidogrel group;there was no difference between the two groups in the re-hospitalization rate for other reasons.3.After 1 year of DAPT treatment in patients with LMCA lesions of coronary heart disease(chest obstruction and heart pain)after PCI,the incidence of secondary endpoints of deficiency of both qi and Yin in the 8 TCM syndromes in the ticagrelor group was lower than that in the clopidogrel group,and there was no difference in the incidence of secondary endpoints of the other 7 syndromes in the two groups.There was no difference in safety endpoints between the two groups of patients with 8 syndromes.There was no difference in re-hospitalization rate due to angina between the two groups of patients with Qi deficiency and blood stasis syndrome.