Comparison of the effect of ticagrelor combined with tirofiban versus clopidogrel combined with tirofiban on inflammation response and prognosis of patients with unstable angina pectoris in long term follow-up

Kaohsiung J Med Sci. 2021 Nov;37(11):1010-1015. doi: 10.1002/kjm2.12421. Epub 2021 Aug 2.

Abstract

To investigate the effect of ticagrelor combined with tirofiban versus clopidogrel combined with tirofiban on inflammation response and prognosis of patients with unstable angina pectoris (UA). The present prospective study included a total of 291 patients who were diagnosed as unstable UA from January 2018 to December 2019. All UA patients were divided into two groups: ticagrelor combined with tirofiban group (n = 159) and clopidogrel combined with tirofiban group (n = 132). Serum levels of C-reactive protein (CRP), interleukin-1β, interleukin-6, tumor necrosis factor-α, and matrix metalloproteinase-9 were measured using commercially available enzyme-linked immunosorbent assay kits. Kaplan-Meier (K-M) curve was performed for analysis of cumulative incidences of major adverse cardiovascular events (MACEs). Both ticagrelor combined with tirofiban and clopidogrel combined with tirofiban significantly decreased the serum levels of inflammatory factors in UA patients. Compared to clopidogrel combined with the tirofiban group, ticagrelor combined with the tirofiban group had a lower platelet aggregation rate and improved cardiac function of UA patients. Besides, ticagrelor combined with tirofiban group had a better prognosis and the K-M curve showed that UA patients treated by ticagrelor and tirofiban had lower incidences of MACEs in one-year follow-up. The treatment of ticagrelor combined with tirofiban significantly attenuated inflammation response and improved the prognosis of UA patients.

Keywords: clopidogrel; ticagrelor; tirofiban; unstable angina pectoris.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angina, Unstable / blood
  • Angina, Unstable / diagnosis
  • Angina, Unstable / drug therapy*
  • Angina, Unstable / mortality
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Clopidogrel / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation
  • Interleukin-1beta / blood
  • Interleukin-6 / blood
  • Kaplan-Meier Estimate
  • Male
  • Matrix Metalloproteinase 9 / blood
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prognosis
  • Prospective Studies
  • Ticagrelor / therapeutic use*
  • Tirofiban / therapeutic use*
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Biomarkers
  • IL1B protein, human
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Platelet Aggregation Inhibitors
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Clopidogrel
  • MMP9 protein, human
  • Matrix Metalloproteinase 9
  • Tirofiban
  • Ticagrelor