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替格瑞洛联合美托洛尔缓释片对老年急性冠状动脉综合征患者经皮冠状动脉介入治疗后心功能及临床预后的影响

Effect of ticagrelor combined with metoprolol extended-release tablets on cardiac function and clinical prognosis in elderly patients with acute coronary syndrome after percutaneous coronary intervention.

作者信息

Wang Lili, Gao Linlin, Chen Qin, Chen Li, Xu Hui, Sun Ling, Hu Youbin

机构信息

Department of Cardiovascular Disease, Taizhou Jiangyan Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu, China.

Department of Orthopedics, Taizhou Jiangyan Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu, China.

出版信息

Front Cardiovasc Med. 2025 Jan 28;12:1492569. doi: 10.3389/fcvm.2025.1492569. eCollection 2025.

Abstract

BACKGROUND

Acute coronary syndrome (ACS) poses significant risks to older individuals. This study sought to assess the impact of combining ticagrelor and metoprolol extended-release tablets on clinical prognosis and cardiac function in elderly ACS patients following percutaneous coronary intervention (PCI).

METHODS

From February 2022 to February 2023, 90 elderly ACS patients who underwent PCI at our institution were retrospectively enrolled and divided into two groups: an observation group (OG) and a control group (CG), with 45 patients in each group. The CG received oral metoprolol extended-release tablets, while the OG received both oral metoprolol extended-release tablets and ticagrelor. Prognostic indicators and cardiac function were evaluated before and after treatment.

RESULTS

The treatment effectiveness rate in the OG was 97.78%, significantly higher than the CG's rate of 77.78% ( < 0.05). Post-treatment, the OG displayed notable improvements in cardiac function, including significantly higher left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), and cardiac index (CI) compared to the CG ( < 0.05). Both groups experienced enhanced exercise capacity, as evidenced by longer exercise duration (ED) and improved 6-min walking test (6MWT) results, with the OG showing superior gains ( < 0.05). Additionally, the OG had significantly higher serum levels of cardiac troponin T (cTnT) and creatine kinase isoenzyme (CK-MB) than the CG ( < 0.05). Decreases in serum levels of sICAM-1, MMP-9, and hs-CRP were observed in both groups, with more pronounced improvements in the OG ( < 0.05). The incidence of adverse prognostic events in the OG was significantly lower at 8.89%, compared to 37.78% in the CG ( < 0.05).

CONCLUSION

Ticagrelor combined with metoprolol extended-release tablets can significantly improve cardiac function, motor performance, and quality of life in ACS patients after PCI. Additionally, it effectively increases myocardial injury markers and reduces serum inflammatory factor levels.

摘要

背景

急性冠状动脉综合征(ACS)对老年人构成重大风险。本研究旨在评估替格瑞洛与美托洛尔缓释片联合应用对老年ACS患者经皮冠状动脉介入治疗(PCI)后临床预后和心功能的影响。

方法

回顾性纳入2022年2月至2023年2月在我院接受PCI的90例老年ACS患者,分为观察组(OG)和对照组(CG),每组45例。CG口服美托洛尔缓释片,OG口服美托洛尔缓释片和替格瑞洛。治疗前后评估预后指标和心功能。

结果

OG治疗有效率为97.78%,显著高于CG的77.78%(<0.05)。治疗后,OG的心功能有显著改善,与CG相比,左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)和心脏指数(CI)显著更高(<0.05)。两组运动能力均增强,运动持续时间(ED)延长和6分钟步行试验(6MWT)结果改善证明了这一点,OG的改善更显著(<0.05)。此外,OG的血清心肌肌钙蛋白T(cTnT)和肌酸激酶同工酶(CK-MB)水平显著高于CG(<0.05)。两组血清sICAM-1、MMP-9和hs-CRP水平均降低,OG改善更明显(<0.05)。OG不良预后事件发生率显著低于CG,分别为8.89%和37.78%(<0.05)。

结论

替格瑞洛与美托洛尔缓释片联合应用可显著改善PCI术后ACS患者的心功能、运动表现和生活质量。此外,它有效增加心肌损伤标志物并降低血清炎症因子水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d6e/11810974/bb67edaf1485/fcvm-12-1492569-g001.jpg

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