Improvement Of Myocardial Perfusion In Patients With Acute Myocardial Infarction By Ticagrelor And Safety Evaluation

Background:Dual antiplatelet therapy and Percutaneous Transluminal Coronary Intervention is the key therapy for acute myocardial infarction.Timely and effective revascularization and anti-platelet aggregation therapy can reduce the area of myocardial infarction,reduce the incidence of adverse events after myocardial infarction,and improve the long-term prognosis of patients.Ticagrelor,as a potent reversible P2Y12 receptor antagonist,has been widely used in the field of double-antiplatelet therapy,and it can increase the concentration of endogenous adenosine by inhibiting the uptake of adenosine by red blood cells and exert a wide range of biological effects.Adenosine can improve cardiac function by interfering with reperfusion injury after myocardial infarction and improving coronary blood flow so as to improve the functional status of microcirculation and viable myocardium.Objective:The purpose of this study was to determine whether ticagrelor can improve myocardial perfusion status by improving microcirculation dysfunction and myocardial function after acute myocardial infarction,and thereby affect cardiac structure and function.Methods:In this research,28 STEMI patients who were undertaken Percutaneous Transluminal Coronary Intervention within 12 hours were included,according to the different type of the DAPT drugs to ticagrelor group(12 cases)and clopidogrel group(16 cases),by comparing the two groups of patients with postoperative 3 days and 30 days left ventricular ejection fraction to reflect the left ventricular systolic function recovery,compare the left ventricular end-diastolic diameter,left ventricular end systolic diameter,interventricular septum thickness,left ventricular posterior wall thickness structure indexes such as cardiac structure to further reaction.The perfusion of microcirculation was evaluated by comparing the results of myocardial contrast echocardiography 7 days after surgery and 30 days after surgery?Compared with uric acid and creatinine conditions before and 30 days after medication,the effects of ticagrelor on uric acid and renal function were determined.MACE events and adverse events were recorded during follow-up.Results:There is no different between general information,and postoperative serum creatinine levels at 30 days before taking the medicine,the heart structure index(left ventricular end-diastolic diameter,left ventricular end systolic diameter,interventricular septum thickness,left ventricular posterior wall thickness),postoperative adverse events of two groups,and on the left ventricular ejection fraction.Compared two groups'left ventricular ejection fraction,there is no difference between two groups between 3 days after PCI.Compared with clopidogrel group,ticagrelor groups improved and has statistical significance in 30days after PCI(30 d:54.25±3.84 vs.51.13±3.85)?Compare clopidogrel group and ticagrelor group separately,30days after PCI compared with 3days improved(p<0.05).The results of myocardial contrast echocardiography at 7 and 30 days showed that the normal perfusion segment of ticagrelor group was significantly increased compared with that of clopidogrel group(c~2=3.844,p=0.049).Blood uric acid levels of the two groups were compared,and there was no significant difference between the two groups'baseline level,and the difference between ticagrelor and clopidogrel group was statistically significant 30 days after the operation(346.25±49.50 vs 302.48±56.89,p=0.043).Conclusion:By comparing the application of ticagrelor and clopidogrel in patients with acute myocardial infarction,this study found that ticagrelor can improve cardiac function by improving myocardial perfusion without increasing blood uric acid,creatinine levels and adverse events,and has positive efficacy and safety.