Comparative study of myocardial perfusion and prognosis in patients with acute myocardial infarction treated by ticagrelor or clopidogrel

Objective To compare the effects of ticagrelor and clopidogrel on platelet aggregation rate, myocardial perfusion and prognosis in patients with acute myocardial infarction. Methods One hundred and sixty-nine patients with acute ST segment elevation myocardial infarction (STEMI) and emergency percutaneous coronary intervention (PCI) were recruited and randomly divided into ticagrelor group (85 cases) and clopidogrel group (84 cases). The TIMI blood flow before and after PCI was recorded, and the ST segment fall rate of 1 h ECG after PCI was calculated. The platelet aggregation rate was measured. After 12 months′ follow-up, the incidence of major adverse cardiac events (MACE) was recorded. The Logistic regression analysis was used to discover the factors of MACE. Results One hundred and sixty-nine patients with acute STEMI were recruited including 85 cases treated with ticagrelor and 84 cases in clopidogrel group. The ECG ST segment fall rate after PCI in ticagrelor group was significantly higher than that in clopidogrel group: (61.3 ± 30.7)% vs. (47.8 ± 26.6)%, P 0.05). Multiple Logistic regression analysis revealed that age and ECG ST segment fall rate were independent risk factors for MACE (P < 0.05). Conclusions Compared with clopidogrel, ticagrelor can effectively reduce platelet aggregation rate and accelerate ST segment fall in STEMI patients, but their long-term prognosis is similar. Key words: Coronary artery disease; Ticagrelor; Clopidogrel; Myocardial perfusion