Effect Of Ticagrelor On Inflammatory Factor And Vascular Endothelial Function In Patients With ACS And Diabetes Undergoing PCI

Objective: This study was designed to investigate the effects of ticagrelor and clopidogrel on inflammatory factory and vascular endothelial function in patients with acute coronary syndrome and diabetes undergoing PCI.Methods: This trial collected 100 patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention from September 2017 to January 2019 in the Department of Cardiology,Second Hospital of Hebei Medical University.Among them,48 patients in the experimental group(telgrelor group)were given ticagrelor(loading dose of 180 mg,maintenance dose of 90 mg twice daily).In the control group(clopidogrel group),52 patients were treated with clopidogrel(loading dose 300 mg,maintenance dose was 75 mg once daily),and the high-sensitivity C-reactive protein and interleukin-6 serological results(before treatment)were obtained before treatment.The brachial artery response test(left side)and double ankle brachial index were also performed before treatment,then patients were given PCI during hospitalization,followed up for 4 weeks,the high-sensitivity C-reactive protein,interleukin-6,ankle brachial index and vascular diameter change were compared between the two groups.Results: Baseline data showed not statistically different.After 4 weeks treatment,interleukin-6 levels were significantly lower in the ticagrelor group than clopidogrel group(6.27(4.73,9.05)mg/L vs 8.48(6.80,11.87)mg/L,P =0.002);There was no significant difference in high-sensitivity C-reactive protein levels between the two groups(3.35(1.93,6.80)pg/ml vs 3.20(1.72,6.70)pg/ml,P =0.887);In terms of vasodilation,in the ticagrelor group,the change of vessel diameter(left)was significantly higher than that in the clopidogrel group(0.40(0.30,0.50)mm vs 0.20.(0.20,0.30)mm,P = 0.000);while the ankle brachial index,there is no significant difference between the two groups(left side 1.00(0.94,1.12)vs 1.00(0.92,1.21),P = 0.64,right side 1.00(0.90,1.19)vs 0.99(0.91,1.18),P = 0.237).Conclusion: For patients with acute coronary syndrome and diabetes undergoing PCI,ticagrelor has more significant anti-inflammatory and vascular endothelial function improvement than clopidogrel...