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The efficacy and safety of the short-term combination therapy with ticagrelor and PPIs or H2RA in patients with acute STEMI who underwent emergency PCI.

Abstract
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.
AuthorsPeng Wei, Shujiang Zhuo, Qiang Fu, Haibo Wang, Bin Zong, Bangming Cao, Liansheng Wang
JournalClinical and translational science (Clin Transl Sci) Vol. 15 Issue 2 Pg. 477-489 (02 2022) ISSN: 1752-8062 [Electronic] United States
PMID34670024 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2021 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.
Chemical References
  • Platelet Aggregation Inhibitors
  • Ticagrelor
Topics
  • Humans
  • Percutaneous Coronary Intervention (adverse effects)
  • Platelet Aggregation Inhibitors (adverse effects)
  • Prospective Studies
  • ST Elevation Myocardial Infarction (drug therapy, surgery)
  • Ticagrelor (adverse effects)
  • Treatment Outcome

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