Combination
therapy with
platelet inhibitors and
acid-suppressive agents is recommended for patients with acute
ST-segment elevation myocardial infarction (
STEMI) who underwent
percutaneous coronary intervention (PCI), but there remains a paucity of data to evaluate both the efficacy and safety of these combinations. In this prospective study, a total of 170 patients with acute
STEMI who underwent PCI were divided into four groups: pantoprazole + ticagrelor, omeprazole + ticagrelor, ranitidine + ticagrelor, and
ticagrelor only. The risk of PCI, antithrombotic efficacy, cardiac function, and main end points were evaluated and compared. No significant differences were found in
infarction-related artery perfusion indexes (thrombolysis in
myocardial infarction [TIMI], corrected TIMI frame count), the incidence of
stent thrombosis after PCI, platelet indicators (platelet count, mean platelet volume, and platelet distribution width), platelet activation (
P-selectin and
glycoprotein IIb/IIIa levels), platelet aggregation (thrombelastography indicators, such as
ADP% and MAADP ), myocardial
necrosis biomarker (
creatine kinase isoenzyme-MB and cardiac
troponin I) levels,
brain natriuretic peptide levels, the incidence of ischemic end point events, and the incidence of other tissue and organ
bleeding events among the four groups. The incidence of gastrointestinal (GI)
bleeding events in the
proton pump-inhibitor (PPI) group was significantly lower than that in the control group, whereas in the H2 receptor antagonist (H2RA) group it was not significantly different from the control group. The short-term combination
therapy with
ticagrelor and PPIs or H2RA is safe and effective in patients with acute
STEMI after PCI. In addition, the PPIs combined with
ticagrelor could reduce the incidence of GI
bleeding events without increasing the incidence of ischemic events.