Effects of ticagrelor and clopidogrel on vascular endothelial function of patients with coronary heart disease

doi:10.3969/j.issn.1004-583X.2021.09.002

Abstract

Abstract:

Objective Some basic studies and clinical trials have shown that P2Y12 receptor antagonists have protective effects on vascular endothelial function. This study was designed to compare the protective effects of ticagrelor and clopidogrel on vascular endothelium. Methods Eighty cases of acute coronary syndrome(ACS) inpatients who underwent percutaneous coronary intervention(PCI) were enrolled. All patients were randomly divided into two groups in a 1∶1 ratio, 40 cases in ticagrelor group with ticagrelor 90 mg twice daily, 40 cases in clopidogrel group with clopidogrel 75 mg once daily. All patients were given aspirin and statins to regulate blood lipids. Serum nitric oxide(NO) and endothelin-1(ET-1) were measured at the admission and after 1-month of the treatment. Results The serum NO of all patients was significantly higher after treatment compared with before administration(P<0.01), but serum ET-1 level was significantly lower (P<0.01). After 1-month treatment, serum NO was significantly higher in ticagrelor group than in clopidogrel group (P<0.01). But the serum ET-1 level was significantly lower in ticagrelor group than in clopidogrel group(P=0.016). Conclusion For patients with ACS undergoing PCI, P2Y12 receptor antagonist has the effect of protecting vascular endothelial function, while ticagrelor can effectively improve the vascular endothelial function, and promote early recovery of vascular function, which is superior to clopidogrel in this respect.

Key words: coronaryt disease, endothelium, vascular, nitric oxide, endothelin-1, ticagrelor, clopidogrel

CLC Number:

R541.4

Guo Jiamin, Zhang Guangming, Yang Jing, Gu Guoqiang, Lu Rui, Xing Hanghang, Cui Wei. Effects of ticagrelor and clopidogrel on vascular endothelial function of patients with coronary heart disease[J]. Clinical Focus, 2021, 36(9): 778-781.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.09.002

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I9/778

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References 18

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项目	替格瑞洛组(n=40)	氯吡格雷组(n=40)	Z/χ²值	P值
男[例(%)]	27(67.5)	32(80.0)	1.614	0.204
年龄(岁)	60.0(53.5,65.0)	58.0(49.0,67.0)	-0.058	0.954
体重指数(kg/m²)	26.0(24.1,27.7)	26.7(23.1,27.8)	-0.433	0.665
吸烟史[例(%)]	15(37.50)	15(37.50)	0.000	0.000
高血压[例(%)]	26(65.00)	20(50.00)	1.841	0.175
糖尿病[例(%)]	13(32.50)	7(17.50)	2.400	0.121
高脂血症[例(%)]	10(25.00)	15(37.50)	1.455	0.228
卒中史[例(%)]	2(5.00)	4(10.00)	0.721	0.396
hs-CRP(mg/L)	1.5(0.9,3.9)	1.5(0.9,3.9)	-0.645	0.519
UA(mmol/L)	293.0(266.0,366.5)	309.0(255.0,403.0)	-0.221	0.825
Cr(μmol/L)	66.0(58.8,75.6)	70.0(63.3,80.0)	-1.530	0.126
TG(mmol/L)	3.6(3.2,4.3)	4.0(3.7,4.5)	-1.954	0.051
LDL-C(mmol/L)	2.2(1.8,3.1)	2.7(2.2,2.9)	-1.720	0.085
FBG(mmol/L)	5.2(4.6,6.5)	5.2(4.7,5.8)	-0.092	0.927
TnI(ng/ml)	<0.01(<0.01,0.2)	<0.01(<0.01,0.1)	-1.740	0.082
BNP(pg/ml)	40.4(10.7,128.3)	25.5(13.8,75.8)	-1.202	0.229
LVEF(%)	62.0(61.3,63.7)	62.0(60.8,63.3)	-0.779	0.436
单支病变[例(%)]	15(37.50)	13(32.50)	0.000	0.000
双支病变[例(%)]	15(37.50)	12(30.00)	0.000	0.000
三支病变[例(%)]	10(25.00)	15(37.50)	1.476	0.478
ACEI/ARB[例(%)]	4(10.00)	6(15.00)	0.457	0.499
β受体阻滞剂[例(%)]	12(30.00)	16(40.00)	0.879	0.348
钙离子拮抗剂[例(%)]	11(27.50)	14(35.00)	0.524	0.469

项目	替格瑞洛组(n=40)	氯吡格雷组(n=40)	Z/χ²值	P值
男[例(%)]	27(67.5)	32(80.0)	1.614	0.204
年龄(岁)	60.0(53.5,65.0)	58.0(49.0,67.0)	-0.058	0.954
体重指数(kg/m²)	26.0(24.1,27.7)	26.7(23.1,27.8)	-0.433	0.665
吸烟史[例(%)]	15(37.50)	15(37.50)	0.000	0.000
高血压[例(%)]	26(65.00)	20(50.00)	1.841	0.175
糖尿病[例(%)]	13(32.50)	7(17.50)	2.400	0.121
高脂血症[例(%)]	10(25.00)	15(37.50)	1.455	0.228
卒中史[例(%)]	2(5.00)	4(10.00)	0.721	0.396
hs-CRP(mg/L)	1.5(0.9,3.9)	1.5(0.9,3.9)	-0.645	0.519
UA(mmol/L)	293.0(266.0,366.5)	309.0(255.0,403.0)	-0.221	0.825
Cr(μmol/L)	66.0(58.8,75.6)	70.0(63.3,80.0)	-1.530	0.126
TG(mmol/L)	3.6(3.2,4.3)	4.0(3.7,4.5)	-1.954	0.051
LDL-C(mmol/L)	2.2(1.8,3.1)	2.7(2.2,2.9)	-1.720	0.085
FBG(mmol/L)	5.2(4.6,6.5)	5.2(4.7,5.8)	-0.092	0.927
TnI(ng/ml)	<0.01(<0.01,0.2)	<0.01(<0.01,0.1)	-1.740	0.082
BNP(pg/ml)	40.4(10.7,128.3)	25.5(13.8,75.8)	-1.202	0.229
LVEF(%)	62.0(61.3,63.7)	62.0(60.8,63.3)	-0.779	0.436
单支病变[例(%)]	15(37.50)	13(32.50)	0.000	0.000
双支病变[例(%)]	15(37.50)	12(30.00)	0.000	0.000
三支病变[例(%)]	10(25.00)	15(37.50)	1.476	0.478
ACEI/ARB[例(%)]	4(10.00)	6(15.00)	0.457	0.499
β受体阻滞剂[例(%)]	12(30.00)	16(40.00)	0.879	0.348
钙离子拮抗剂[例(%)]	11(27.50)	14(35.00)	0.524	0.469

组别	例数	NO(μmol/L)		ET-1(pg/ml)
组别	例数	治疗前	治疗后	治疗前	治疗后
替格瑞洛组	40	2.89(2.57,4.39)	5.39(4.63,8.41)^*	211.17(188.23,265.59)	187.52(168.95,239.01)^*
氯吡格雷组	40	2.96(2.45,4.49)	4.14(3.24,5.37)^*	257.32(186.24,413.89)	243.76(184.17,398.78)^*
Z值		-0.144	-3.536	-1.099	-2.408
P值		0.885	<0.001	0.272	0.016

组别	例数	NO(μmol/L)		ET-1(pg/ml)
组别	例数	治疗前	治疗后	治疗前	治疗后
替格瑞洛组	40	2.89(2.57,4.39)	5.39(4.63,8.41)^*	211.17(188.23,265.59)	187.52(168.95,239.01)^*
氯吡格雷组	40	2.96(2.45,4.49)	4.14(3.24,5.37)^*	257.32(186.24,413.89)	243.76(184.17,398.78)^*
Z值		-0.144	-3.536	-1.099	-2.408
P值		0.885	<0.001	0.272	0.016