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《Chinese Journal of Difficult and Complicated Cases》 2017-01
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The effect of ticagrelor on contrast induced nephropathy in acute coronary syndrome patients underwent emergency percutaneous coronary intervention

ZHENG Xueyang;LI Na;HUANG Zhigang;TANG Zhen;WANG Liming;Department of Renal Transplantation,Second Military Medical University Affiliated Changzheng Hospital;  
Objective To compare the effect of ticagrelor and clopidogrel on contrasl induced nephropathy(CIN) in acute coronary syndrome patients underwent emergency percutaneous coronary intervention(PCI).IVIethods Clinical data of221 acute coronary syndrome patients who had received emergency PCI was retrospectively analyzed,118 cases in the ticagrelor group,103 cases in the elopidogrel group.The serum creatinine(SCr),estimate glomerular filtration rate(eGFR)and CIN incidence of before PCI or 72 hours after PCI from patients in both groups were compared.Results The general data and medication of both groups were comparable.The SCr and incidence of CIN after PCI in licagrelor group were higher than those in elopidogrel group[SCr:(112.0 ± 23.2) μmol/L vs.(106.5 ± 19.7) μmol/L,t = 1.834,P = 0.068;CIN;6.8%vs.4.8%,x~2 =0.368,P =0.544],and the eGFR in ticagielor group was lower than that in the elopidogrel group[(81.4 ±21.5) ml/min~(-1) · 1.73m~(-2) vs.(83.2±20.3) ml/min~(-1) · 1.73m~(-2),t =0.637,P =0.525),but the differences were not statistically significant(P 0.05).Analysis of the two groups of patients with moderate to severe renal insufficiency showed higher SCr(133.3±12.1 μmol/L vs.126.0 ± 12.lμmol/L,t =2.140,P =0.038) and lower eGFR(42.3 ±6.2 ml/min~(-1) ·1.73m~(-2) vs.46.7 ±7.5 ml/min~(-1)· 1.73m~(-2),t =2.246,P =0.029) in ticagielor group than those in elopidogrel group,the difference was statistically significant(P 0.05).The incidence of CIN was higher in the patients with moderate to severe renal insufficiency in ticagrelor group than those in elopidogrel group,however,there was no statistical significance(P 0.05).Conclusion In all patients with ACS who underwent emergency PCI,the general incidence of CIN in ticagielor group and elopidogrel group had no difference.However,increased incidence of CIN was observed in patients with moderate to severe renal insufficiency in ticagrelor group.Prophylactic treatments should be helpful to these patients in the perioperative period.
【Fund】: 国家自然科学基金资助项目(81303111)
【CateGory Index】: R541.4
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