Influence Of Ticagrelor And Clopidogrel On Inflammation And Ischemia-reperfusion Injury For STEMI Patients Received Percutaneous Coronary Intervention

ObjectiveBy comparasion of white blood cell count and percentage of neutrophils before PCI and 24hours.7days after PCI,discuss the different influence of ticagrelor and clopidogrel on inflammation and ischemia-reperfusion injury for STEMI patients received percutaneous coronary intervention with total occlusion of right coronary artery.MethodsCheck back 350 patients enrolled ISSBRIL0249 Study and filtrate patients who meet the following criteria:1.male aged between 30s and 60s.2.total occlusion of right coronary artery.3.available date of routine analysis of blood before PCI and 24hours、7days after PCI.4.TIMI3 level of the blood flow of right coronary artery and killip I level of cardiac functional grading.5.without infectious disease a week before PCI and duration of hospital stay.6.routine treatment of aspirin and statins.7.without adverse drug reaction to Ticagrelor and Clopidogrel and without switching drugs.Then all subjects were divided into 2 groups:ticagrelor group:(before PCI:aspirin 300mg st ticagrelor 180mg st after PCI:aspirin 100mg qd ticagrelor 90mg bid)and clopidogrel group(before PCI:aspirin 300mg st clopidogrel 600mg st after PCI:aspirin 100mg qd clopidogrel 75mg qd).Collect patients data as follows:age,history of smoking、angina pectoris、diabetes and ischemic stroke,the time from onset of disease to the emergency room,blood index before PCI of serum potassium、blood platelet count,blood index 24 hours after PCI of blood glucose、low density lipoprotein、triglyceride、creatinine.Meanwhile,white blood cell count and percentage of neutrophils before PCI and 24 hours、7 days after PCI were recorded.By comparasion of white blood cell count and percentage of neutrophils before PCI and 24 hours,7 days after PCI,discuss the different influence of ticagrelor and clopidogrel on inflammation.Selecte patients furtherly whose white blood cell count 24 hours after PCI exceeds white blood cell count before PCI from the 50 patients and discuss the different influence of ticagrelor and clopidogrel on ischemia-reperfusion injury for STEMI Patients with total occlusion of right coronary artery received percutaneous coronary intervention by comparasion of white blood cell count and percentage of neutrophils before PCI and 24 hours.Results1.Select 50 subjects from 350 patients:ticagrelor group 24 people,clopidogrel group 26 people.select 19 subjiects whose white blood cell count 24 hours after PCI exceeds white blood cell count before PCI from 50 patients:ticagrelor group 8 people,clopidogrel group 11 people.2.Age,history of smoking、angina pectoris、diabetes and ischemic stroke of two group(50 people)are all no significant statistic difference(chi-square test:P>0.05).3.The time from onset of disease to the emergency room、blood index before PCI of serum potassium、blood platelet count,blood index 24 hours after PCI of blood glucose、low density lipoprotein、triglyceride、creatinine of two group(50 people)are all no significant statistic difference(two independent samples t-test:P>0.05).4.White blood cell count and percentage of neutrophils before PCI and 24 hours,7 days after PCI of two group(50 patients)were no significant statistic difference(two independent samples t-test:P>0.05).5.A11 subjects(50 patients)are divided into 2 groups according to the time from onset of disease to the emergency room:T≥3h and T<3h,the proportion of people whose white blood cell count 24 hours after PCI exceeds white blood cell count before PCI between two groups(chi-square test:p<0.05)is significant statistic difference and proportion of T<3h group is higher.6.White blood cell count and percentage of neutrophilsins before PCI and 24 hours after PCI of two group(19 patients)are no significant statistic difference(two independent samples t-test:P>0.05).Conclusion1.The influence of ticagrelor and clopidogrel on inflammation is no significant difference for STEMI patients received percutaneous coronary intervention.2.The influence of ticagrelor and clopidogrel on ischemia-reperfusion injury is no significant difference for STEMI patients received percutaneous coronary intervention.3.Ischemia time span is the influence factor of ischemia-reperfusion injury.