Recent Antiplatelet Efficacy and Incidence of Adverse Reactions in Patients with Acute ST Segment Elevation Myocardial Infarction Treated with Tigrillo
WANG Li-jie, HAN Dan-ning
Xi'an Xihang Hospital of Universal,Xi'an Shaanxi 710021
Abstract：【Objective】To investigate the recent antiplatelet efficacy and adverse reactions of Tigrillo in the treatment of acute ST segment elevation myocardial infarction (STEMI) patients. 【Methods】A retrospective analysis was conducted on the clinical data of 85 patients with acute STEMI who underwent emergency PCI treatment in our hospital from January 2018 to June 2020. They were divided into two groups based on different antiplatelet treatment drugs:the Tigrillo group and the clopidogrel group. We compared the general clinical data,platelet related indicators,platelet inhibition rate,TIMI grading,corrected TIMI frame count,as well as the occurrence of major adverse reactions and endpoint events between two groups of patients. 【Results】There was no significant difference in the inhibition rate of arachidonic acid (AA%) and residual platelet activity (MAAA) in the AA induction pathway between the two groups at admission,24 hours after taking the drug,and 7 days after taking the drug (P>0.05). 24 hours after administration and 7 days after administration,the inhibition rate of adenosine diphosphate (ADP%) in the Tigrillo group was higher than that in the clopidogrel group,and the residual platelet activity (MAADP) in the ADP induction pathway was lower than that in the clopidogrel group,with a statistically significant difference (P<0.05). After 7 days of medication,the proportion of patients with TIMI grade III in the Tigrillo group was higher than that in the clopidogrel group,and the corrected TIMI frame counts of the anterior descending branch,circumflex branch,and right coronary artery were all lower than those in the clopidogrel group,with statistically significant differences (P<0.05). There was no statistically significant difference in the incidence of adverse reactions such as dyspnea,bradycardia,skin ecchymosis,and bleeding between the two groups of patients (P>0.05); There was no statistically significant difference in endpoint events such as cardiac death,recurrent myocardial infarction,and emergency coronary revascularization between the two groups of patients (P>0.05). 【Conclusion】 The application of Tigrillo in STEMI patients undergoing PCI treatment has a better inhibitory effect on platelet aggregation than clopidogrel,and can reduce the occurrence of no/slow reflux without increasing the incidence of adverse reactions and primary endpoint events. The safety is good.
王丽杰, 韩丹宁. 替格瑞洛治疗急性ST段抬高型心肌梗死患者的近期抗血小板疗效及不良反应发生情况[J]. 医学临床研究, 2023, 40(5): 699-702.
WANG Li-jie, HAN Dan-ning. Recent Antiplatelet Efficacy and Incidence of Adverse Reactions in Patients with Acute ST Segment Elevation Myocardial Infarction Treated with Tigrillo. JOURNAL OF CLINICAL RESEARCH, 2023, 40(5): 699-702.
[1] 谢炜巍,夏陈海,王汝涛,等.替罗非班联合尼可地尔对急性 ST 段抬高型心肌梗死患者 PCI 术后疗效及对患者心功能的影响[J].医学临床研究,2021,38(8):1256-1258. [2] BARALIS G,ROSSINI R,MUSUMECI G. Antiplatelet therapy in STEMI undergoing primary PCI:when,which one and how long[J].Minerva Cardioangiol,2018,66(4):422-428. [3] CHARFI R,MZOUGHI K,BOUGHALLEB M,et al. Response to clopidogrel and of the cytochrome CYP2C19 gene polymorphism[J].Tunis Med,2018,96(3):209-218. [4] WILLIAMS B,HENDERSON R A,REFORMATO V S,et al. Hemostasis management of patients undergoing emergency cardiac surgery after ticagrelor loading[J].J Cardiothorac Vasc Anesth,2020,34(1):168-174. [5] JAMES S,AKERBLOM A,CANNON C P,et al. Comparison of ticagrelor,the first reversible oral P2Y(12) receptor antagonist,with clopidogrel in patients with acute coronary syndromes:Rationale,design,and baseline characteristics of the PLATelet inhibition and patient Outcomes (PLATO) trial[J].Am Heart J,2009,157(4):599-605. [6] JUNG C,ELSÄSSER A. Update ESC-Leitlinie 2017-Akuter Myokardinfarkt (STEMI)[J].Dtsch Med Wochenschr,2018,43(11):797-801. [7] VOGEL B,CLAESSEN B E,ARNOLD S V,et al. ST-segment elevation myocardial infarction[J].Nat Rev Dis Primers,2019,5(1):39. [8] FRANCHI F,ROLLINI F,ANGIOLILLO D J. Antithrombotic therapy for patients with STEMI undergoing primary PCI[J].Nat Rev Cardiol,2017,14(6):361-379. [9] OTHMAN M,KAUR H. Thromboelastography (TEG)[J].Methods Mol Biol,2017,1646:533-543. [10] SAEVERAAS S B,SEGHATCHIAN J,SIVERTSEN J,et al.The use of thromboelastography (TEG) in massively bleeding patients at Haukeland University Hospital 2008-15[J].Transfus Apher Sci,2019,58(1):117-121. [11] DA LUZ L T,NASCIMENTO B,SHANKARAKUTTY A K,et al. Effect of thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) on diagnosis of coagulopathy,transfusion guidance and mortality in trauma:descriptive systematic review[J].Crit Care,2014,18(5):518. [12] MEGA J L,SIMON T. Pharmacology of antithrombotic drugs:an assessment of oral antiplatelet and anticoagulant treatments[J].Lancet,2015,386(9990):281-291.
2023, Vol. 40 
