A Comparative Study Of Ticagrelor And Clopidogrel In Patients With Chd Combined With Hhcy Undergoing PCI

Objective: By comparing the application of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease(CHD)combined with Hhcy undergoing percutaneous coronary intervention(Percutaneous Coronary Intervention,PCI),in this special kind of patients with high risk of ischemia and hemorrhage,its antiplatelet therapy after PCI provides a preliminary clinical evidence for efficacy and safety.Methods:Patients who were admitted to the Department of Cardiology of Xiangtan Central Hospital from May 2018 to October 2018 and were treated with ticagrelor and clopidogrel who diagnosed as Coronary Heart Disease combined with Hhcy and successfully completed PCI revascularization were selected as the research objects.The clinical data were retrospectively analyzed.According to the inclusion criteria,exclusion criteria,and completed follow-up data we totally enrolled 101 patients.(We divided these patients into two groups based on antiplatelet drugs:(ticagrelor-group(n=49)and clopidogrel-group(n=52)).Collectbaseline datas between the two groups and compare whether there are statistical differences between the groups.The primary endpoint of the study was to compare the incidence of total Major Adverse Cardiovascular and Cerebrovascular Events(MACCE)events:Stroke(ischemic),unstable angina,recurrent myocardial infarction,revascularization,and cardiogenic death)one year after operation.Safety indicators include: the incidence of major bleeding events,minor bleeding events,and minimal bleeding one year after operation;Other safety indicator is dyspnea.All data statistics were analyzed using SPSS18.0 statistical analysis software.Results:(1)There was no statistical difference in baseline datas between the clopidogrel and ticagrelor groups(gender,age,smoking history,body mass index,laboratory indicators,left ventricular ejection fraction,combined medication and disease),the type of CHD and PCI status(P>0.05).(2)Compared with clopidogrel,ticagrelor can reduce the total MACCE(8.16% VS 32.69%,P<0.05)and the incidence of unstable angina pectoris events(0.00% VS 13.46%,P<0.05)in patients with hyperhomocysteinemia PCI 1 year after operation.The incidences of stroke,unstable angina pectoris,recurrent myocardial infarction,and cardiogenic death were compared separately between the two groups,andthe difference was not statistically significant(P> 0.05).(3)The incidence of major bleeding events,minor bleeding events,and minimal bleeding events were similar between the two groups,and the difference was not statistically significant(4.08% VS 0.00%;4.08%VS 1.92%;20.41%VS 9.62%;P>0.05);but the total bleeding events of ticagrelor were more than those of clopidogrel group(28.57% VS11.54%,P<0.05).(4)There was no significant difference in the incidence of dyspnea in the ticagrelor and clopidogrel group(4.08% VS 0.00%,P> 0.05).Conclusion:In the clinical treatment of patients with CHD combined with Hhcy undergoing PCI,compared with clopidogrel,ticagrelor can significantly reduce the overall MACCE and the incidence of unstable angina pectoris within 1 year after PCI;and does not increase the incidence of major,secondary,and minimal bleeding.