Clinical efficacy and safety of reteplase combined with ticagrelor for the treatment of acute ST-segment elevation myocardial infarction

LI Zheng-rong; ZHAO Jian-ye; ZHANG Zong-lin; SHI Zeng-cheng; ZHANG Shou-wen; WEI Yan-jin

Abstract：Objective:To explore the clinical efficacy and safety of reteplase (rPA) combined with ticagrelor for the treatment of acute ST-segment elevation myocardial infarction (STEMI) and provide reference for safe medication in clinical practice.Methods:We retrospectively reviewed 67 consecutive patients enrolled in Linyi People's Hospital Affiliated to Shandong University from March 2013 to December 2014,who were diagnosed with STEMI and treated with intravenous thrombolysis treatment.They were divided into two groups:the study group (rPA combined with ticagrelor,n =32) and the control group (tPA combined with clopidogrel,n =35).Then the clinical characteristics,the average CCU stay,the rate of artery blood vessel recanalization,angina after infarction,heart failure,cardiac death,bleeding and the adverse drug events of the two groups were compared.Results:The recamalization rates at 30,60,90 and 120 min were higher in the study group than in the control group.At 60 min,the recamalization rates were 65.6％ and 34.3％ in the study group and control group,with statisticallysignificant difference between the two groups (P--0.020).At 120 min,the recamalization rates were 93.8％ and 74.3％ in the study group and control group,with statistically significant difference between the two groups (P =0.032).The rate of angina after infarction was 12.50％ in the study group and 31.43％ in the control group.The rate of heart failure was 6.26％ in the study group and 11.43％ in the control group.The rate of cardiac death was 3.13％ in the study group and 5.71％ in the control group,respectively,with no significant differences in the two groups (P＞0.05).The average CCU stay was (4.53±1.48) d in the study group and (5.26±-1.34,) d in the control group,respectively,with significant differences in the two groups (P =0.04).The rate of severe bleeding was 9.38％ in the study group and 0 in the control group.The rate of dyspnea was 0 in the study group and 6.25％ in the control group,respectively,with no significant differences in the two groups (P ＞ 0.05).Conclusion:rPA combined with ticagrelor is significantly effective for the treatment of STEMI,but may increase the risk of severe bleeding.It is necessary to choose appropriate indications and expand the study sample to further confirm the efficacy and safety.