Efficacy and safety of preoperative Ticagrelor at different doses before percutaneous coronary intervention in elderly patients with ST segment elevation myocardial infarction
Objective To investigate the efficacy and safety of different doses of Ticagrelor before percutaneous coronary intervention(PCI)in the treatment of elderly patients with ST segment elevation myocardial infarction(STEMI).Methods A total of 78 elderly patients with STEMI admitted to Tianchang Hospital of Traditional Chinese Medicine of Anhui Province from July 2018 to June 2021 were selected and divided into control group(Aspirin 300 mg + Ticagrelor 90 mg preoperatively)and observation group(Aspirin 300 mg+ Ticagrelor 180 mg preoperatively)by random number table method,with 39 cases in each group.The platelet parameters,myocardial enzyme spectrum indexes,and coronary blood flow were compared between the two groups before and after treatment.The incidence of major adverse cardiovascular and cerebrovascular events during hospitalization were compared between the two groups.Results Before treatment,there were no significant differences in platelet count,plateletcrit(PCT),and mean platelet volume(MPV)between the two groups(P>0.05);after treatment,the platelet count in the two groups was lower than that before treatment,the PCT and MPV were higher than those before treatment,and platelet count in the observation group was lower than that in the control group,the PCT and MPV were higher than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in myoglobin(MB),lactate dehydrogenase(LDH),alpha-hydroxy acid dehydrogenase(HBDH),and cardiac troponin I(cTnI)between the two groups(P>0.05);after treatment,MB,LDH,HBDH,and cTnI in the two groups were lower than those before treatment,and those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in coronary flow velocity reserve(CFVR),left anterior descending systolic peak velocity(SPV),and diastolic peak velocity(DPV)of left anterior descending artery between the two groups(P>0.05);after treatment,the CFVR,SPV,and DPV in the two groups were higher than those before treatment,and those of the observation group were higher than the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the total incidence of major adverse cardiovascular and cerebrovascular events between the two groups during hospitalization(P>0.05).Conclusion Elderly STEMI patients who received loading dose of Ticagrelor before PCI has better effect.