Study On The Relationship Between Ticagrelor-related Dyspnea And Hemorrhagic Events After PCI In Patients With Acute Coronary Syndrome

Objective: Acute coronary syndrome is a group of clinical syndromes caused by acute myocardial ischemia,which is also the main cause of death.Dual antiplatelet therapy is the cornerstone of patient management after ACS or percutaneous coronary intervention.A guideline updated by the European Society of Cardiology and the American Heart Association in recent years to recommend ticagrelor for DAPT in patients with ACS or PCI.Ticagrelor has the characteristics of rapid onset and strong effect,and has side effects such as bleeding and difficulty in breathing.This article aims to investigate the relationship between ticagrelor-related dyspnea and postoperative PCI bleeding events in patients with acute coronary syndrome and to compare the differences in platelet aggregation rate,major cardiovascular events,and bleeding rates between the two groups.Methods:The subjects were enrolled in the Department of Cardiology,Hebei General Hospital,and the patients with acute coronary syndrome(ACS)underwent PCI,and 114 patients with aspirin and ticagrelor were given.The patients were given aspirin 300 mg and ticagrelor 180 mg before surgery.except medication contraindications,according to the absence of dyspnea,divided into dyspnea group(20 cases)and no breathing difficulty group(94 cases),comparing platelet aggregation rate of 7 days and 1 month after operation,MACE occurred within 6 months Rate and incidence of bleeding events.SPSS 21.0 was used to analyze all the data.Measurement data were described using mean ± standard deviation.The mean comparison between the two groups was performed by t test;the count data was recorded as a percentage,and the count data was determined by 2 test or exact probability method.Results:1.Comparison of platelet aggregation rate between the two groups.The arachidonic acid(AA)aggregation rate and Adenosine diphosphate(ADP)aggregation rate all decreased in both groups,AA aggregation rate decreased more significantly after 1 month in the dyspnea group,there was no statistically significant difference in ADP aggregation rate between the two groups at 7 days and 1 month.2.The incidence of bleeding events in the two groups was slightly hemorrhage in the two groups.There were 2 cases of epistaxis in the observation group,2 cases of skin mucosal hemorrhage,4 cases of gingival bleeding,1 case of hematuria in control group,2 cases of epistaxis,and 3 cases of gingival bleeding.10 cases of skin mucosal hemorrhage,the incidence of bleeding in the observation group was higher than the control group,the difference was statistically significant(P <0.05).The above treatment options for bleeding are discontinued or reduced,and the symptoms can be improved.3.The incidence of MACE events in the two groups.There was no significant difference in the incidence of stent thrombosis,recurrent myocardial infarction,stroke,and sudden cardiac death between the two groups.Conclusions:In patients without dyspnea,the incidence of bleeding was higher in patients with dyspnea,suggesting that dyspnea is a predictor of bleeding events.