The effect of ticagrelor on contrast induced nephropathy in acute coronary syndrome patienst underwent emergency percutaneous coronary intervention

ZHENG Xueyang; LI Na; HUANG Zhigang; TANG Zhen; WANG Liming

doi:10.3969/j.issn.1671-6450.2017.01.001

Abstract：Objective To compare the effect of ticagrelor and clopidogrel on contrast induced nephropathy ( CIN) in acute coronary syndrome patients underwent emergency percutaneous coronary intervention (PCI).Methods Clinical data of 221 acute coronary syndrome patients who had received emergency PCI was retrospectively analyzed , 118 cases in the ti-cagrelor group, 103cases in the clopidogrel 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 ticagrelor group were higher than those in clopidogrel group[SCr:(112.0 ±23.2)μmolL/vs .(106.5 ±19.7)μmol /L, t =1.834, P =0.068; CIN:6.8%vs.4.8%,χ2 =0.368, P =0.544], and the eGFR in ticagrelor group was lower than that in the clopidogrel 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 ±12.1μmol/L vs.126.0 ±12.1μmol/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 ticagrelor group than those in clopidogrel group , the difference was statistically significant ( P <0.05).The incidence of CIN was higher in the patients with moderate to se-vere renal insufficiency in ticagrelor group than those in clopidogrel 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 ticagrelor group and clopidogrel 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 .