The Effect Of Ticagrelor On Coronary Microcirculation And Inflammatory Factors After PCI In Patients With Acute Coronary Syndrome

Objective: To evaluate the effect of ticagrelor on coronary microcirculation and inflammatory factors in patients with acute coronary syndrome after PCI.Methods: 72 patients with acute coronary syndrome who were treated in our hospital from September 2018 to November 2020 were selected and divided into ticagrelor group(n=38)and clopidogrel group(n=34),All the selected population underwent PCI treatment.The baseline data,PCI-related data and the intraoperative no-reflow rate,left ventricular end-diastolic diameter,left ventricular ejection fraction,and the results of offline analysis of myocardial contrast echocardiography were compared between the two groups of patients.Compare the Level of hypersensitivity C-reactive protein(hs CRP),lipoprotein phospholipase A2(Lp-PLA2),interleukin-6(IL-6),homocysteine(Hcy)Level before surgery and 1 month follow-up.Results: There were no significant differences in baseline data,PCI-related data,intraoperative no-reflow rate,preoperative left ventricular end-diastolic diameter,left ventricular ejection fraction,and offline analysis results of myocardial contrast echocardiography between the two groups(P>0.05).There was no significant difference in the left ventricular end-diastolic diameter of the ticagrelor group compared with the clopidogrel group at 1 month after operation((45.00± 4.59)mm vs(45.47± 3.41)mm,P>0.05);The left ventricular ejection fraction has a trend of improvement compared with the clopidogrel group,but there was no statistical difference((64.36± 5.21)% vs(63.57± 5.76)%,P>0.05);The results of offline analysis of myocardial contrast echocardiography at 1 month after operation showed that the peak intensity(A)value of myocardial imaging in the ticagrelor group was significantly higher than that in the clopidogrel group((12.61± 3.36)d B vs(11.67 ± 2.24)d B,P<0.05),and the average slope(β)value of the curve rising to the plateau((1.26± 0.32)/s vs(1.21± 0.41)/s,P>0.05)was no significant difference,local myocardial blood flow(A·β)value((15.57 ± 2.99)d B/s vs(13.73 ± 4.01)d B/s,P<0.05)significantly increased at 1 month after surgery.The preoperative hypersensitivity C-reactive protein,lipoprotein phospholipase A2 levels,interleukin-6 and homocysteine levels were not significantly different between the two groups of patients(P>0.05).Compared with clopidogrel group,ticagrelor group hypersensitive C-reactive protein(2.15(1.50,2.75)mg/L vs(2.30(1.90,3.25)mg/L,P<0.05),interleukin-6 level((6.18± 1.35)pg/ml vs(6.94± 1.62)pg/ml,P<0.05)and homocysteine level((10.90 ± 2.82)umol/L vs(12.51 ± 3.75)umol/L,P<0.05)significantly decreased.There was no signifi-cant difference in lipoprotein phospholipase A2 levels between the two groups((143.15±24.18)ng/m L vs(148.14± 30.10)ng/m L,P>0.05).Conclusion: Compared with clopidogrel,ticagrelor can improve coronary microcirculation and reduce inflammatory response in patients with acute coronary syndrome after PCI,and has a trend of improving heart function.