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Study the effect of glycemic control on response to clopidogrel and ticagrelor in patients with Type 2 Diabetes Mellitus(T2DM) and acute myocardial infarction (AMI).
A total of December 2014 to 2015 years 11 months in Shanxi Provincial Cardiovascular Hospital intensive coronary care unit hospitalization for coronary interventional therapy for AMI patients complicated with T2DM 160, were randomly divided into clopidogrel and ticagrelor group 80 patients in each, according to admission glycosylated hemoglobin levels respectively for good glycemic control subgroup and poor glycemic control subgroup, treatment 7 Tianxing thromboelastography figure detection of adenosine diphosphate (ADP) induced platelet gathered inhibition rate (IPA).
1. In the clopidogrel group blood sugar control good IPA subgroup ADP induced higher blood glucose control negative sub group (68.6 + 23.3) vs (50.1 + 23.8%, P=0.015] glycemic control good sub group in response to clopidogrel low less than glucose control negative sub group (22.45% than 48.39%, P = 0.016);
2. For ticagrelor group blood sugar control good IPA subgroup ADP induced higher blood glucose poorly controlled subgroup [(73.9 + 23.6%) vs 63.4 + 20.5%), P = 0.009], blood glucose control good sub group for ticagrelor low less than blood glucose poorly controlled subgroup (7.14% than 23.68%, P = 0.039). 3. in the clopidogrel group blood sugar control negative sub group ADP induced IPA below control negative sub group of ticagrelor group (50.1 + 23.8)%VS (63.4 + 20.5)%, P=0.037]; clopidogrel group blood sugar control good subgroup and blood glucose control adverse subgroup drugs with low responders were significantly greater than those of ticagrelor group (22.45%VS 7.14%, P = 0.044; 48.39%VS23.68%, P = 0.032).
The level of blood glucose control in patients with AMI combined with T2DM affects the anti platelet effect of clopidogrel and ticagrelor, and the IPA is higher in the ticagrelor group than in the clopidogrel group.