Background: Ischemic heart disease remains the leading cause of death in both developed and under developed countries. The use of antiplatelet drugs specifically the thienopyridine has become a standard for the treatment of acute coronary syndrome. These drugs irreversibly inhibit the platelet aggregation by blocking the P2Y12 receptor. But currently this therapeutic choice has become limited due to potential interaction with other drugs, slow hepatic conversion, genetic resistance and narrow therapeutic safety margin. Ticagrerol, a reversible P2Y12 receptor inhibitor may represent a significant advancement over currently available oral antiplatelet drugs.Objectives: The study was intended to compare the effect of Ticagrelor and Clopidogrel on oxidative stress markers in patients of chronic stable angina (CSA) following percutaneous coronary intervention (PCI).Materials & Methods: The present prospective observational study was carried out in the Department of Pharmacology, Cardiology and Microbiology, BSMMU, Dhaka from September 2014 to February 2016. The study included a total of 100 CSA patients. Patients were divided into two groups, Ticagrelor and Clopidogrel treated groups (each having 50 patients). The baseline laboratory parameters-Malondihyde (MDA), Reduced glutathione (GSH), bleeding time, clotting time and platelet count, were measured and then patients of both groups underwent PCI. The same parameters were again assessed at follow up after 4 weeks of intervention. Total 12 patients from Ticagrelor and 14 patients from Clopidogrel groups were dropped out. Comparisons of the laboratory parameters were made between two groups at baseline and at follow up and also within group before and after intervention.Result: In the present study at baseline characteristics of patients treated with ticagrelor and clopidogrel were almost identical in terms of age, sex, diabetes and hypertension. The level of plasma MDA in ticagrelor group was significantly reduced from baseline to follow up(4.5 ± 1.8 to 1.4 ± 0.7, p <0.001) and in clopidogrel group (4.2 ± 1.2 to 1.3 ± 0.7, p <0.001). GSH level was increased from 0.7 mg/dl to 2.5 mg/dl (p <0.001) in ticagrerol group and in clopidogrel group 0.6 mg/dl to 1.4 mg/dl, p <0.001).Conclusion: The study concluded that both ticagrelor and clopidogrel are similar effect on oxidative stress markers, resulting from oxidative injury processes in patients of chronic stable angina.University Heart Journal Vol. 12, No. 1, January 2016; 26-30

Introduction:Coronary heart disease (CAD) is a major global health problem. 1 Low and middle income countries, including South Asian countries like India and Pakistan, contribute significantly to the global burden of cardiovascular disease. A projection made by Murray and Lopez showed that by 2020, 78% of all deaths and 86.3% of all loss of disability adjusted life years (DALYs) will be attributable to this cause. 2 The malondialdehyde and reduced glutathione are sensitive markers of oxidative stress. 3 In normal cell metabolism, free radicals are generated by biochemical redox reactions.Due to this oxidative injury leads to increase the thrombotic effect, in patients of ACS following PCI.As ticagrelor has the antiplatelet effect if it produced anti-oxidative effect which reduced the thrombotic phenomenon as well as oxidative stress and then reduce the risk of CAD. Pathogenesis of a variety of vascular diseases including atherosclerosis, hypertension and coronary artery disease are implicated by reactive oxygen species (ROS) which are produced from oxidative stress. 4 In coronary artery disease there is alteration in oxidant-antioxidant profile. In coronary artery disease, increased secretion of TNF-á which contributes to depression of extracellular SOD activity. 5 This leads to endothelial dysfunction in coronary artery disease by increasing free radical load and inactivation of NO by superoxide anions forming peroxynitite. 5 In Pharmacology, anti- Effect of Ticagrelor versus Clopidogrel on

Background: Ischemic heart disease remains the leading cause of death in both developed and under developed countries. The use of antiplatelet drugs specifically the thienopyridine has become a standard for the treatment of acute coronary syndrome. These drugs irreversibly inhibit the platelet aggregation by blocking the P2Y12 receptor. But currently this therapeutic choice has become limited due to potential interaction with other drugs, slow hepatic conversion, genetic resistance and narrow therapeutic safety margin. Ticagrerol, a reversible P2Y12 receptor inhibitor may represent a significant advancement over currently available oral antiplatelet drugs.Objectives: The study was intended to compare the effect of Ticagrelor and Clopidogrel on inflammatory and oxidative stress markers in patients of chronic stable angina (CSA) following percutaneous coronary intervention (PCI).Materials & Methods: The present prospective observational study was carried out in the Department of Pharmacology, Cardiology and Microbiology, BSMMU, Dhaka from September 2014 to February 2016. The study included a total of 100 CSA patients. Patients were divided into two groups, Ticagrelor and Clopidogrel treated groups (each having 50 patients). The baseline laboratory parameters- High sensitive C-reactive protein (hs-CRP), bleeding time, clotting time, were measured and then patients of both groups underwent PCI. The same parameters were again assessed at follow up after 4 weeks of intervention. Total 12 patients from Ticagrelor and 14 patients from Clopidogrel groups were dropped out. Comparisons of the laboratory parameters were made between two groups at baseline and at follow up and also within group before and after intervention. Result: In the present study at baseline characteristics of patients treated with Ticagrelor and Clopidogrel were almost identical in terms of age, sex, diabetes and hypertension. The inflammatory marker hs-CRP was also similar in both groups at baseline. At follow up hs-CRP was significantly reduced from baseline 19.7 mg/dl to 1.7 mg/dl (p value- 0.001) in ticagrerol group and 18.4 mg/dl to 2 mg/dl (p value-0.001) in clopidogrel group. There was no significant change in bleeding time and clotting time in both groups of patients.Conclusion: The study concluded that both Ticagrelor and Clopidogrel are similar in improving the status of the inflammatory marker, resulting from inflammatory processes in patients of chronic stable angina.University Heart Journal Vol. 11, No. 1, January 2015; 42-44

Introduction: Hyperlipidemia is a major risk for the development of atherosclerosis leading to cardiovascular complications. Atorvastatin and rosuvastatin are two widely used important members of the HMG-CoA reductase inhibitor (statins). The beneficial effects of statins on clinical events also involve lipid-independent mechanisms which include improvement of oxidative stress status. Objective: To compare the antioxidative effect of atorvastatin and rosuvastatin in patients with hyperlipidemia. Materials and Methods: A prospective randomized single-center analytic study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from March 2016 to August 2017 on 52 hyperlipidemic patients. After randomization patients were assigned to atorvastatin 10 mg or rosuvastatin 5 mg daily for 8 weeks. Blood was collected at baseline and after the intervention to measure plasma malondialdehyde (MDA), erythrocyte reduced glutathione (GSH) (as biomarkers of oxidative stress) and serum lipid profile. Results: The baseline characteristics of patients treated with atorvastatin and rosuvastatin were almost identical. The level of plasma MDA in atorvastatin (1.35 ± 0.94 to 0.97± 0.64) and rosuvastatin (1.56±0.69 to 0.98±0.38) group was significantly reduced after intervention (28.15%, p<0.05 and 37.18%, p<0.001 respectively) but no statistically significant difference (p>0.05) was observed between the two statin-treated groups. Erythrocyte GSH level was increased after intervention in both atorvastatin (2.43±2.90 to 4.14 ± 4.87) group (70.37%, p<0.01) and rosuvastatin (2.76±3.80 to 8.36±12.93)  group (202.90%, p<0.01), which was statistically significant. No significant difference was observed between the two groups (p>0.05). Both atorvastatin and rosuvastatin significantly improved serum lipid profile. Conclusion: Both atorvastatin and rosuvastatin significantly improved oxidative stress status in hyperlipidemic patients but no significant change was observed between the two statin-treated groups. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 54-58