Clinical application of TiGraylo in acute coronary syndrome with clopidogrel resistance

Objective To investigate the clinical efficacy of the new third generation of antiplatelet drug: platelet adenosine monophosphate(ADP) receptor antagonist P2Y12- TiGrayLo in the treatment of acute coronary syndrome(ACS) with clopidogrel resistance. Methods Randomly selected 66 ACS patients were planned for coronary stent implantation(PCI). All patients took clopidogrel(300 ~ 600mg load) before the surgery. The patients were divided into two groups based on the thromboelastography- determined platelet inhibition rate within 24 hours after taking clopidogrel. The clopidogrel- resistant group,defined by platelet inhibition rate 31%,included 6 patients; the normal group,defined by platelet inhibition rate 50%,included 60 patients. The two groups had significant difference in platelet inhibition rate( P 0. 001). The patients in clopidogrel- resistant group were treated with oral TiGraylo,first dose 180mg,followed by 90mg twice a day for one year. The patients in normal group were treated with oral clopidogrel 75mg once a day for one year. Results After treatment with TiGraylo,the clopidogrel- resistant group had platelet inhibition rate returned to normal,and slightly higher than those in the normal group. The two groups had no significant difference in platelet inhibition rate(P 0. 05). No acute or subacute coronary artery and stent thrombosis were observed after PCI. There was no obviously increased bleeding rate.Conclusion Compared to Clopidogrel,TiGrayLo can significantly reduce the incidence of cardiovascular events in ACS patients without increasing bleeding and can also prevent the acute and subacute thrombosis in patients with clopidogrel resistance.