The Efficacy And Safety Of Loading Dose Ticagrelor In STEMI Patients With Intravenous Thrombolysis Therapy

Objective: To evaluate the efficacy and safety of loading dose ticagrelor in STEMI patients with intravenous thrombolysis therapy.Methods:1.Between October 2015 and December 2017,100 STEMI patients underwent intravenous thrombolysis therapy using Pro-UK,were treated with loading dose ticagrelor(180mg)followed by 90 mg bid(n=50)or loading dose clopidogrel(300mg)followed by 75 mg qd(n=50).2.The patients' general conditions such as age,gender,and coronary heart disease risk factors?sum ST segment resolution in ECG,Troponin I peak before 12 hours,CK-MB peak before 14 hours,chest pain relief at 2 hours,reperfusion arrhythmia and clinical bleeding events in the following 24 hours were recorded.The bleeding standard of clinical bleeding events were TIMI bleeding standard and BARC definition for bleeding criteria.3.Data were analyzed by SPSS21.0 statistical software.Results: The 90 min sum ST segment resolution in ECG in clopidogrel and ticagrelor group were 60%(42.25%)and 70%(30%)(P=0.06).The rate of the patients who had Troponin I peak before 12 hours,CK-MB peak before 14 hours were 76% and 84% in the two groups(P=0.32).Patients' chest pain relief at 2 hours in the two groups were 84% and 94%(P=0.11).46% of the patients in clopidogrel group and 60% of the patients in ticagrelor group had reperfusion arrhythmia(P=0.16).The rate of revascularization was 82% and 86%(P=0.59).By the TIMI bleeding standard,clinical bleeding results in the two groups were major bleeding(0% and 0%,P=1.00),Minor bleeding(2% and 4%,P=1.00),Minimal bleeding(14% and 16%,P=0.78).By the BARC definition for bleeding criteria,clinical bleeding results were Type 1(8% and 6%,P=1.00),Type 2(8% and 10%,P=1.00),Type 3a(0% and 4%,P=0.48),Type 3b(0% and 0%,P=1.00).Conclusions:1.In STEMI patients treated with intravenous thrombolysis therapy using Pro-UK,compared with loading dose clopidogrel,administration of loding dose ticagrelor before thrombolysis therapy,has advantage in myocardial reperfusion level with no significant difference,and there is no significant difference in recanalization rate in the following 24 hours.2.In STEMI patients treated with intravenous thrombolysis therapy using Pro-UK,administration of loading dose ticagrelor or loding dose clopidpgrel have no difference in major bleeding,Minor bleeding and Minimal bleedings in the following 24 hours.