Short-term efficacy of ticagrelor in acute ST-segment elevation myocardial infarction patients undergoing an emergency percutaneous coronary intervention

Cao, Bangming; Qu, Fuzheng; Xianliang, Liu; Gao, Changzheng; Fu, Qiang; Jiang, Chunying; Wei, Peng; Ma, Qianqian

doi:10.18632/aging.102353

Cited by 4 publications

(5 citation statements)

References 28 publications

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“… 9 Currently, the guidelines have pointed out that emergency PCI was the preferred method to open the diseased vessels in STEMI patients and to realize revascularization. 10 A previous study have demonstrated that the peak values of CK and CK-MB were positively correlated with the infarct size of STEMI patients 11 , which was consistent with our results, that is, higher peak values of CK and CK-MB were associated with larger the infarct size. It has been suggested the gold standard for successful reperfusion was to reach TIMI3 blood flow in the infarction-related vessels.…”

Section: Discussionsupporting

confidence: 92%

Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction

et al. 2020

Pak J Med Sci

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Objectives: To investigate the effects of etibatide combined with emergency percutaneous coronary intervention (PCI) on blood perfusion and cardiac function in acute myocardial infarction (AMI) patients. Methods: This was a prospective, randomized, controlled study. From November 2015 to June 2019, 196 patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI admitted to Baoding First Central Hospital were enrolled. The 196 STEMI patients were randomly divided into experimental group and control group. In the experimental group, STEMI patients were treated with emergency PCI + etibatide; while in the control group, only PCI was performed. Observation indexes included: general data, myocardial perfusion and cardiac function indexes and major adverse cardiac events (MACE). Results: There was no significant difference in general data between the two groups (P > 0.05). The rate of ST-segment resolution (STR) in the experimental group was better than that in the control group (P < 0.05). In myocardial contrast echocardiography (MCE), higher peak intensity (PI) and shorter time-to-peak (TP) were observed in the experimental group compared with the control group (P < 0.05). The platelet aggregation rate was compared between the two group at the time points of before PCI, after PCI and two hour after drug withdrawal, and there was no significant change in the platelet aggregation rate of the control group between different time points (before PCI, after PCI and two hour after drug withdrawal); while the platelet aggregation rate of the experimental group was significantly lower after PCI and two hour after drug withdrawal than that before PCI (P < 0.05), and an obviously decreased platelet aggregation rate was found in the experimental group(P < 0.05). After three months of follow-up, there was one case of MACE in the experimental group and 1 case of MACE in the control group, without any difference in the incidence of MACE between the two groups (P > 0.05). Conclusion: Etibatide combined with emergency PCI could improve myocardial reperfusion and cardiac function in patients with acute STEMI without increasing the incidence of MACE. doi: https://doi.org/10.12669/pjms.37.1.2950 How to cite this:Hu Y, Qi F, Yu L, Geng W. Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction. Pak J Med Sci. 2021;37(1):185-190. doi: https://doi.org/10.12669/pjms.37.1.2950 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 92%

Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction

et al. 2020

Pak J Med Sci

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“…Five publications were eliminated (one article investigated the ACS population but lacked detailed data on STEMI patients; four trials did not focus on STEMI patients; in one trial, indicators of microcirculation did not appear in other studies). We finally included seven RCTs (16)(17)(18)(19)(20)(21)(22) in the present analysis.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Ticagrelor vs. clopidogrel for coronary microvascular dysfunction in patients with STEMI: a meta-analysis of randomized controlled trials

Guo

et al. 2023

Front. Cardiovasc. Med.

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PurposeApproximately half of ST-segment elevation myocardial infarction (STEMI) patients who undergo revascularization present with coronary microvascular dysfunction. Dual antiplatelet therapy, consisting of aspirin and a P2Y12 inhibitor (e.g., clopidogrel or ticagrelor), is recommended to reduce rates of cardiovascular events after STEMI. The present study performed a pooled analysis of randomized controlled trials (RCTs) to compare effects of ticagrelor and clopidogrel on coronary microcirculation dysfunction in STEMI patients who underwent the primary percutaneous coronary intervention.MethodsThe PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible RCTs up to September 2022, with no language restriction. Coronary microcirculation indicators included the corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC), myocardial blush grade (MBG), TIMI myocardial perfusion grade (TMPG), coronary flow reserve (CFR), and index of microcirculatory resistance (IMR).ResultsSeven RCTs that included a total of 957 patients (476 who were treated with ticagrelor and 481 who were treated with clopidogrel) were included. Compared with clopidogrel, ticagrelor better accelerated microcirculation blood flow [cTFC = −2.40, 95% confidence interval (CI): −3.38 to −1.41, p < 0.001] and improved myocardial perfusion [MBG = 3, odds ratio (OR) = 1.99, 95% CI: 1.35 to 2.93, p < 0.001; MBG ≥ 2, OR = 2.57, 95% CI: 1.61 to 4.12, p < 0.001].ConclusionsTicagrelor has more benefits for coronary microcirculation than clopidogrel in STEMI patients who undergo the primary percutaneous coronary intervention. However, recommendations for which P2Y12 receptor inhibitor should be used in STEMI patients should be provided according to results of studies that investigate clinical outcomes.

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“…PPCI is the standard and preferred treatment in STEMI with acceptable efficacy compared to other treatment options [ 15 ]. In a clinical trial conducted in 2019 by Cao et al [ 16 ], the short-term outcomes of the STEMI patient candidates for PPCI who received ticagrelor or clopidogrel were compared. There was no significant difference between the two groups regarding TIMI flow grade zero, grade I, and grade II; However, grade III TIMI flow was more frequent in the ticagrelor group than in the clopidogrel group ( p =0.016).…”

Section: Discussionmentioning

confidence: 99%

The Comparison of the Initial TIMI Flow Grade in Acute ST-Elevation Myocardial Infarction Patients Receiving Ticagrelor vs. Clopidogrel before Undergoing Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Elahifar,

Rafati,

Alemzadeh-Ansari

et al. 2024

Cardiology Research and Practice

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Objective. Primary percutaneous coronary intervention (PCI) is the best treatment for acute ST-elevation myocardial infarction (STEMI). Evidence is in favor of ticagrelor over clopidegrel in STEMI patients regarding the reduction of stent thrombosis risk during and after PCI. We compared initial thrombolysis in myocardial infarction (TIMI) flow in STEMI patients on ticagrelor vs. clopidogrel. Methods. This prospective cohort recruited 160 patients with acute STEMI, referred to the emergency department of Farshchian Heart Center, during March 2018–2019. Before angiography, the patients received clopidogrel (600 mg) or ticagrelor (180 mg) on top of aspirin. Initial TIMI flow was compared between the two groups as the primary outcome. A logistic regression was performed to calculate the predictors of initial TIMI flow. Analyses were performed using R, version 4.2.1. Results. In ticagrelor and clopidogrel groups, the mean ± standard deviation age of the patients was 59.46 ± 13.11 and 61.34 ± 11.08 years (p value = 0.33), respectively. In the ticagrelor and clopidogrel groups, initial TIMI flow grades were as follows: 0 : 50% and 71.2%, I: 26.2% and 16.2%, II: 12.5% and 10%, and III: 12.9% and 2.5%, respectively (p value = 0.005). Final TIMI flow grades were as follows: I: 26.2% and 16.2%, II: 7.5% and 13.8%, and III: 66.3% and 70%, respectively (p value = 0.41). Ticagrelor was associated with significantly higher initial TIMI flow grade compared to the clopidogrel group (adjusted odds ratio: 2.90 (95% CI: 1.51–5.72)). Conclusion. In STEMI patients who were candidates for primary PCI, ticagrelor administration led to a better initial TIMI flow grade compared to clopidogrel.

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Short-term efficacy of ticagrelor in acute ST-segment elevation myocardial infarction patients undergoing an emergency percutaneous coronary intervention

Cited by 4 publications

References 28 publications

Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction

Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction

Ticagrelor vs. clopidogrel for coronary microvascular dysfunction in patients with STEMI: a meta-analysis of randomized controlled trials

The Comparison of the Initial TIMI Flow Grade in Acute ST-Elevation Myocardial Infarction Patients Receiving Ticagrelor vs. Clopidogrel before Undergoing Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

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