A Comparative Study On The Effect Of Aspirin Combined With Ticagrelor And Aspirin Combined With Clopidogrel On The Incidence Of Hyperuricemia In Patients With Acute Coronary Syndrome

Objective: To compare the effects of aspirin combined with ticagrelor and aspirin plus clopidogrel on the incidence of hyperuricemia in patients with acute coronary syndrome(ACS).Methods: A total of 476 patients with ACS admitted to the Department of Cardiology,Shengjing Hospital,China Medical University from February 2018 to December 2018 were enrolled.According to different antiplatelet regimens applied to patients after percutaneous coronary intervention,243 patients were divided into patients with aspirin 100mg/d combined with clopidogrel 75mg/d and 233 patients with aspirin100mg/d combined with ticagrelor 90mg/bid.The serum uric acid level and incidence of hyperuricemia at 7 days,1 month,3 months and 6 months were observed.Results: There were no significant differences in gender and age between the two groups(P>0.05).There was no significant difference in preoperative serum uric acid levels between the two groups(P=0.238).at 1 month,3 months,6 months,the incidence of hyperuricemia in the ticagrelor group was higher than the clopidogrel group,Statistically significant(x~2 values ? ? were 7.623,20.367,14.018,P<0.05);multivariate logistic regression analysis showed that after adjusting for confounding factors,there was still a difference between ticagrelor and clopidogrel in the incidence of hyperuricemia in patients with ACS [β=-1.139,SE=0.249,Wald x~2=20.903,OR=0.320,95% CI(0.196,0.522)];Repeated measurement design analysis showed that the blood uric acid levels in the two groups varied with the time of medication,and there was an interaction between the medication group and the medication time(F=6.201,P<0.05).Conclusion: compared with the clopidogrel group,the ticagrelor group has a greater influence on the serum uric acid level of patients with ACS.The prevalence of hyperuricemia is higher.The blood uric acid level peaks at 3 months after treatment.Clinician needs to pay attention to the management of blood uric acid.It is recommended that patients should review blood uric acid levels at least 1 month and 3months after medication,so as to facilitate timely adjustment of medication and early intervention.