Effects of switching of dual antiplatelet therapy in STEMI patients

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Purpose. To assess of the relationship between the level of the platelet aggregation and of interleukin-6 (IL-6) and C-reactive protein (CRP) in STEMI patients receiving clopidogrel or switching therapies to ticagrelor. Methods. The study enrolled 80 patients with STEMI. At the ambulance all patients received a loading dose of aspirin (250 mg) and clopidogrel (600 mg). After 24 hours patients were received with maintenance dose of aspirin (100 mg) and of clopidogrel 75 mg/ticagrelor 90 mg twice a day. ADP-induced platelet aggregation (1.25 and 2.5 mgr/ml), levels of IL-6 and CRP in blood plasma were assessed before switching therapies to ticagrelor and on the 7th day after switching therapies to ticagrelor. Results. On the 7th day after switching therapies to ticagrelor, platelet aggregation was significantly lower in patients on ticagrelor than in patients on clopidogrel (C: 45.61 [32.7; 56]%, T: 30.3 [13.3; 41.6]%, p=0.001). The level of CRP on the 7th day in the clopidogrel group was significantly higher than the level of CRP on the 7th day in the ticagrelor group: 25.3 (4.6; 46.4) ml/l and 17.5 (4.6; 20.9) mg/l, respectively (p=0.04). The level of IL-6 on the 7th day in the clopidogrel group was significantly higher than the level of IL-6 on the 7th day in the ticagrelor group: 7.03 (2.7; 11.3) pg/ml, and 2.8 (1.8; 4.2) pg/ml, respectively (p=0.01). Conclusion. On the 7th day after switching therapies to ticagrelor in STEMI patients levels of inflammatory markers (IL-6, CRP) were significantly higher in the group where ADP-induced platelet aggregation was higher.

About the authors

E. V Tavlueva

Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo Cardiology Centre

Email: tavlev1@mail.ru
д-р мед. наук, вед. науч. сотр. лаб. патофизиологии мультифокального атеросклероза, ФГБНУ НИИ КПССЗ; зав. отд-нием неотложной кардиологии ГБУЗ «КОККД им. акад. Л.С.Барбараша» 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6; 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6

A. V Alekseenko

Kemerovo Cardiology Centre

Email: a_kem.2009@mail.ru
врач-кардиолог отд-ния неотложной кардиологии №1, ГБУЗ «КОККД им. акад. Л.С.Барбараша» 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6

O. V Gruzdeva

Research Institute for Complex Issues of Cardiovascular Diseases

Email: o_gruzdeva@mail.ru
д-р мед. наук, зав. лаб. исследований гомеостаза, ФГБНУ НИИ КПССЗ 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6

O. L Barbarash

Research Institute for Complex Issues of Cardiovascular Diseases

Email: OLB61@mail.ru
чл.-кор. РАН, д-р мед. наук, проф., дир. ФГБНУ НИИ КПССЗ 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6

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