The Efficacy And Safety Of Ticagrelor Reduction Under The Guidance Of Platelet Aggregation Rate

Objective:To evaluate the efficacy and safety of the application of half dose ticagrelor on patients with acute ST-segment elevation myocardial infarction(STEMI)guided by platelet aggregation rate(PAg R).Methods: This study was a single-center,prospective study.Patients selected were those with acute ST-segment elevation myocardial infarction(STEMI)in The Second Hospital of Hebei Medical University reexamined one month after the p-PCI from January 2016 to June 2017 and they were divided into three groups according to their PAgR after one month of the operation.Patients of Group A were those treated with standard ticagrelor and PAgR > 25%,group B with standard ticagrelor and PAgR < 25%,and group C with clopidogrel.The ticagrelor for group B was halved at one month after PCI.PAgR was reexamined at 1 week and 1 month after grouping.major adverse cerebral and cardiac event(MACCE)and adverse reactions after 6 months after operation were compared.Results:There was no significant difference in baseline data of the three groups(P>0.05).The baseline values of PAgR of the three groups were not statistically different(P>0.05).Compared with baseline value,the PAgR of the three groups all decreased 1 month after PCI,1 week after grouping,and 1 month after grouping(P<0.001).The PAgR in the group with half dose ticagrelor was significantly lower than that in the group with standard ticagrelor and the group with clopidogrel at 1 month after PCI(P<0.001).The PAgR value of the half-dose group was higher than that of the standard dose group,but lower than that of the clopidogrel group.There was no significant difference in PAgR between the standard dose group and the half-dose group(P>0.05).The PAgR value of the standard dose group and the half-dose group were both lower than that of the clopidogrel group,which showed a significant difference(P < 0.05).There was no significant difference in the incidence of MACCE among the three groups(P>0.05),and no significant difference among the three groups in the incidence of major and minor bleeding(P=0.127),but the incidence of minimal bleeding in the standard dose group was higher than that in the half dose group and clopidogrel group,which was significant difference(P=0.03).For the incidence of dyspnea,The incidence of standard dose group was significantly higher than that of half dose group and clopidogrel group(P = 0.01).Conclusions:1.Both standard dose of ticagrelor and half-dose ticagrelor showed effective platelet inhibition and were stronger than clopidogrel.2.It is efficacy and safety of the application of half dose ticagrelor on patients with acute ST-segment elevation myocardial infarction(STEMI)guided by platelet aggregation rate(PAgR).