Effect Of Ticagrelor On Incidence Of Contrast Induced Nephropathy In Patients Undergoing Elective Coronary Stent Implantation

Objective:The use of contrast agents can lead to the increase of serum creatinine,and for ticagrelor,it can also lead to the increase of serum creatinine.If the use of ticagrelor and contrast medium will aggravate the occurrence of contrast induced nephropathy,there is still no clinical research at home and abroad.Therefore,it is of important clinical significance to explore whether there is a difference in the incidence of contrast agent nephropathy with different P₂Y₁₂ receptor antagonists in selected PCI patients.The effects of ticagrelor and clopidogrel on the incidence of contrast nephropathy（contrast induced nephropathy,CIN）in selected PCI patients were compared.Methods:According to the criteria for admission and the standard of exclusion,a retrospective analysis of 245 patients scheduled for selected PCI from January 2014 to September 2016 in Number Four of Wuhan hospital of west area was conducted.Among them,58 were in the group of ticagrelor and 187 in the group of clopidogrel group.The general statistics of patients（age,gender,weight,height,BMI）,smoking,heart rate,left ventricular EF,hypertension,diabetes,hyperlipidemia,medication（CCB,beta receptor antagonists,ACEI or ARB,renal protective drugs,contrast agent type and dosage,Nitrates）the serum creatinine level before surgery and 72 hours after PCI,creatinine difference,creatinine absolute value,serum uric acid difference,and the occurrence of CIN from patients in both groups were compared.Results:The general data of patients undergoing elective PCI,ticagrelor group and clopidogrel group of both groups of clinical data,smoking,heart rate,left ventricular EF,hypertension,diabetes,hyperlipidemia,medication（CCB,beta receptor antagonist,ACEI or ARB,renal protective drugs,contrast agent type and dosage,Nitrates）,there was no statistically significant difference（P>0.05）.There was no statistical significance of preoperative Scr and SUA level difference（P>0.05）;so was it that no statistical significance after comparison of 72h Scr and SUA level difference（P>0.05）.However,the both group were compared before and after 72 hours Scr difference,the absolute value of Scr and SUA difference,and the differences were statistically significant（P<0.05）.Nevertheless,There was no statistically significant in the incidence of CIN in the both groups（P>0.05）.Conclusions:This study showed that,the ticagrelor group significantly increased serum creatinine and uric acid levels in patients with elective PCI,compared with the clopidogrel group.Although the incidence of CIN has no statistical significance,still,that ticagrelor in high-risk patients with CIN may Aggravated damage the function of renal made us wary.A large prospective clinical research still needs to be confirmed.It is necessary to have a preventive treatment in the perioperative period of PCI.