Abstract:
AIM To explore the safety and feasibility of ticagrelor after failed thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI).
METHODS Patients with STEMI who were failed in the thrombolytic treatment were continuously enrolled in the chest pain center of the Second Hospital of Hebei Medical University from January 2018 to December 2019. All patients were randomly divided into the clopidogrel group and the ticagrelor group after emergency intervention treatment, and were given oral clopidogrel 75 mg, 1 /d and ticagrelor 90 mg, 2 / d. Changes in platelet aggregation rate (PAR) and high-sensitivity C-reactive protein (hs-CRP) were compared between the two groups before and (5-7) days after treatment. The incidence of major adverse cardiac events (MACE) during the hospitalization of the two groups was compared.
RESULTS The patients were randomly divided into the clopidogrel group (n = 32) and the ticagrelor group (n = 33). There were no significant differences in baseline data between the two groups. Compared with the clopidogrel group, the levels of CK, CK-MB, and cTnI in the ticagrelor group were lower (P < 0.05, P < 0.01). The left ventricular end-diastolic diameter (LVEDD) of the ticagrelor group had a decreasing trend, and there was no significant difference in left ventricular ejection fraction (LVEF). Logistic regression analysis showed that diabetes was related to the occurrence of bleeding events during hospitalization in STEMI patients who received rescue intervention after failed thrombolysis.
CONCLUSION For patients with STEMI who have failed thrombolysis, the use of ticagrelor therapy after rescue coronary intervention is safe and feasible.
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