Role of ticagrelor in treatment of elderly AMI patients undergoing emergency PCI

Objective To study the therapeutic effect and safety of ticagrelor in elderly ST-segment elevation AMI patients undergoing emergency PCI.Methods Four hundred and seventeen elderly ST-segment elevation AMI patients undergoing emergency PCI in our hospital from January 2013 to June 2014 were divided into ticagrelor treatment group(n=124)and clopidogrel treatment group(n=293).The patients in ticagrelor treatment group were treated with 180 mg ticagrelor followed by 90 mg(twice a day)before operation and those in clopidogrel treatment group received 300 mg clopidogrel followed by 75 mg(once a day)after operation.The TIMI blood flow was compared between the two groups after operation.The incidence of major adverse cardiovascular events and the safety of the two drugs were observed in the two groups 30 days after operation.Results The TIMI 3blood flow rate and ST-segment reduction rate were significantly higher while the platelet aggregation rate was significantly lower in ticagrelor treatment group than in clopidogrel treatment group(P0.05,P0.01).The incidence of mild bleeding was significantly higher in ticagrelor treatment group than in clopidogrel treatment group(12.9% vs 8.2%,P=0.035).Conclusion Ticagrelor can inhibit platelet aggregation more effectively than clopidogrel.Emergency PCI can improve the blood flow and myocardial perfusion in elderly ST-segment elevation AMI patients with a high safety and no major bleeding.