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Percutaneous coronary intervention (PCI) is an important method in the treatment of acute coronary syndrome (ACS). Dual antiplatelet drug therapy has been used as the main means to inhibit the thrombosis of the lesion site after PCI, and aspirin with clopidogrel is the most common. But there are still recurrent ischemic events, such as in- stent restenosis and thrombosis. As the incidence of aspirin and clopidogrel “cannot tolerate” or “resistance” rising, and often the incidence of clinical events also gradually increased. In this study, 132 cases of acute coronary syndrome undergoing PCI were randomly divided into two group, one group is aspirin combined with clopidogrel, the other one is cilostazol and ticagrelor, to study the safety and efficacy of percutaneous coronary intervention for patients with digestive system disease with cilostazol and ticagrelor.
A total of 132 acute coronary syndrome patients with percutaneous coronary intervention were divided into two groups. One group had 44 patients, who because of previous history of peptic ulcer disease, other medical history cannot tolerate aspirin, or had clopidogrel resistance, was given 90mg Ticagrelor Bid,50mg Cilostazol bid, dual antiplatelet therapy for 1 year. Other group accepted percutaneous coronary intervention in the same period, was given 100mg aspirin qd, and clopidogrel 75 mg qd for 1 year. Other drug treatments were same to coronary heart disease secondary prevention drugs (beta blockers and ACEI, statins, etc). Recorded major cardiac adverse events and bleeding tendency after 1 month, half year, and one year.
One months after surgery, ticagrelor group without bleeding, 3 cases of bleeding events in clopidogrel group, were BARC1 type, P = 0.550 (P > 0.05), the difference was not statistically significant. After one year, the incidence rate of MACE in ticagrelor group was 2.3%, less than the clopidogrel group (4.5%), P = 0.664 (no significant differences between groups), no significant differences between the two groups in bleeding (P = 1). Comparison between two groups, the major adverse cardiac events (MACEs)and bleeding events had no significant difference.
Cilostazol combined with for Ticagrelor, dual antiplatelet treatment after coronary artery interventional treatment of acute coronary syndrome patients, increase neither the risk of hemorrhage cases, nor the incidence of MACE, is safe and effective, its effect on platelet aggregation is not inferior to aspirin and clopidogrel, especially for patients who cannot tolerate aspirin or clopidogrel resistance.