Efficacy and safety of loading dose ticagrelor before PCI in patients with acute coronary syndromes

Objective To explore the safety and efficacy of loading dose of ticagrelor and clopidogrel before percutaneous coronary intervention( PCI) in patients with emergency acute myocardial infarction( AMI). Methods Eighty-four emergency AMI patients treated with emergency PCI in 12 hours,who were randomly divided into clopidogrel group( 40 cases,600 mg loading dose) and ticagrelor group( 44 cases,180 mg loading dose) in one hour before PCI. Two groups followed by 75 mg daily thereafter. Observation time was 7 d,follow-up time was 30 d. To observe the platelet aggregation rate and postoperative TIMI flow before treatment,medication 0. 5 h,2 h,24 h,2 d and 7 d,and the composite endpoint and adverse events within 30 d. Results In clopidogrel group,the platelet aggregation rate in medication of 0. 5 h,2 h,24 h was 81. 28% ± 9. 81%,62. 06% ± 8. 80%,59. 31% ± 13. 11%,the overall incidence of adverse reactions was65. 00%; ticagrelor group was 64. 35% ± 11. 46%,43. 73% ± 6. 40%,45. 96% ± 11. 90% and 20. 45%; all P 0. 01.Clopidogrel overall incidence of the composite endpoint events,postoperative TIMI 3 flow grade were 2. 50%,80. 00%; ticagrelor group were 2. 27%,77. 27%; both P 0. 05. Conclusion Emergency AMI patients before PCI using a loading dose of ticagrelor had more significant role in the early inhibition of platelet compared with clopidogrel,and without increasing bleeding,lower incidence of the gastrointestinal reactions.