Effects Of Ticagrelor And Clopidogrel On Vascular Endothelial Function In Patients With Coronary Heart Disease

Objectives: Endothelial dysfunction plays an important role in the occurrence and development of coronary heart disease(CHD).Some basic studies and clinical trials have shown that ticagrelor and clopidogrel have protective effects on vascular endothelial function.This study was designed to compare the protective effects of ticagrelor and clopidogrel on vascular endothelium.Methods:1.Eighty cases of Acute coronary syndrome(ACS)patients who underwent percutaneous coronary intervention(PCI)in department of cardiology in our hospital were selected.After successful enrollment,all patients was randomly divided into 2 groups in a 1:1 ratio.The basic information was obtained and serum nitric oxide(NO)and endothelin-1(ET-1)levels were measured at the same time.Group Ticagrelor(40 cases)were treated with ticagrelor 90 mg twice daily,Group Clopidogrel(40 cases)were treated with clopidogrel 75 mg once daily.All patients were given aspirin enteric-coated tablets(100mg)once daily after admission.Each group was treated with statins(no restrictions)to regulate blood lipids and isosorbide mononitrate tablets to dilate coronary arteries.NO and ET-1 were measured again 1 month after treatment and the changes of NO and ET-1 were compared before and after treatment.2.The results were analyzed by SPSS 25.0 statistical software.The counting data was represented by the number of cases(percentage),and the analysis method was performed by chi-square test.Since the measurement data does not obey the normal distribution,the measurement data is described by means of median(lower quartile,upper quartile),and the analysis method uses rank sum test to compare between groups.Paired rank sum test was usedto compare the data of patients before and after treatment.Set inspection level P=0.05.Results:1.The serum NO content of all patients was significantly higher than that before administration(P<0.001),and the serum ET-1 level was significantly lower than that before administration(P<0.001).2.After one month of drug treatment,the serum NO content in the ticagrelor group was significantly higher than that of the clopidogrel group(P < 0.001),while the serum ET-1 level was significantly lower than that of the clopidogrel group(P=0.016).Conclusions:Ticagrelor can effectively improve the vascular endothelial function and promote early recovery of vascular function in ACS patients with PCI,which is superior to clopidogrel in this respect.