Efficacy Of Ticagrelor And Clopidogrel In Reducing Inflammatory Markers In Patients With Coronary Heart Disease And Hypertension

Introduction:Coronary atherosclerotic heart disease is one of the most common cardiovascular diseases in clinic,antiplatelet has become the key point in the treatment of coronary heart disease at present,and for coronary heart disease patients,Coronary restenosis after Percutaneous coronary intervention(PCI)plays an important role in prevention.Hypertension is an important risk factor for cardiovascular,renal and neurovascular diseases.A sustained increase in blood pressure triggers a series of mechanobiological reactions in the arteries.The objective of this study was to evaluate the efficacy of ticagrelor and clopidogrel in improving vascular function by observing and comparing the statistical difference between the two drugs in reducing associated markers of inflammation.Methods:A total of 242 patients with coronary heart disease and hypertension admitted to the cardiovascular department of our hospital from January 2019 to March 2021 were retrospectively analyzed,and were divided into Ticagrelor group(n=123)and clopidogrel group(n=119)according to the use of dual antiplatelet drugs after PCI.Platelet/lymphocyte ratio(PLR),Monocyte/lymphocyte ratio(MLR)and Neutrophil/lymphocyte ratio(NLR)were calculated based on blood routine at admission,1 month,3 months and 6 months after discharge.Multiple linear regression was used to analyze the influencing factors of PLR,MLR and NLR.Results:There were statistically significant differences in inflammatory indexes in Ticagrelor group before and after treatment at 1 month,3 months and 6 months(p<0.001),while there were no statistically significant differences in inflammatory indexes in clopidogrel group before and after treatment at 1 month,3 months and 6months(p>0.05).PLR(p=0.005),MLR(p=0.007),NLR(p=0.025)at 1 month after discharge,PLR(p=0.009),MLR(p<0.001),NLR(p=0.001)at 3 months after discharge,PLR(p=0.009),MLR(p=0.007)and NLR(p<0.001)were all lower than those in clopidogrel group.According to the decrease or increase of inflammatory indicators in the review,the decrease rates of inflammatory indicators PLR(p=0.008),MLR(p=0.007)and NLR(p=0.172)in the two groups after 1 month of medication were obtained,and PLR(p=0.012),MLR(p<0.001),NLR(p=0.002)in the two groups after 3 months.After 6 months,PLR(p=0.006),MLR(p=0.003),NLR(p<0.001)were decreased.According to the results of multiple linear regression analysis,platelet,creatinine,total cholesterol,triglyceride,low density lipoprotein,gender and blood pressure grade are significant influencing factors of PLR,creatinine,triglyceride and gender are significant influencing factors of MLR,creatinine,total cholesterol,triglyceride,blood pressure grade and troponin are significant influencing factors of NLR.Conclusions:With the prolongation of medication time,the difference in the effectiveness of the two drugs in the treatment of inflammatory indicators was gradually significant.The levels of PLR,MLR and NLR were lower in patients with coronary heart disease and hypertension treated with ticagrelor after 1 month,3 months and 6months.Compared with clopidogrel,ticagrelor can more effectively reduce inflammatory markers in patients with coronary heart disease and hypertension after PCI,thus improving vascular function.