Abstract: [
Abstract ] Objective Toinvestigatetheeffectsofticagrelorinhigh-riskcoronarypatients
whohavehighon-treatmentplateletreactivity ( HTPR ) withclopidogrelafterpercutaneous
coronaryintervention ( PCI ) .Methods Atotalof209patientswithstableorunstableanginawho
hadbeenreceivingclopidogreltreatmentwereselected.VerifyNow P2Y12assay wasusedto
detecttheplateletreactivity.HTPRwasdefinedasP2Y12reactionunits ( PRU ) ≥208.Subjects
wererandomizedintoHTPRgroup ( n =97 ) andnon-HTPRgroup ( n =112 ) .Totally , 63patients
inHTPRgroupprecededPCI , individualsreceivedPCIwithHTPRwererandomlyassignedinto
clopidogreltreatmentgroup ( n =30 ) andticagrelortreatmentgroup (
n =33 ), receivingeither
additionalclopidogrel300mgorticagrelor180mgbeforecoronaryangiography.Allthepatients
continuedwithclopidogrelorticagrelortreatmentafterPCI.Clinicalcharacteristicand PCI
relatedparametersforsubjectswhounderwentPCIwererecorded.TroponinandPRUlevelswere
determinedbeforeandafterPCI , postoperativebleedingandmajoradversecardiovascularevents rateswereassessedafterPCI.Results Nosignificantdifferencesofclinicalcharacteristicsand
PCIrelatedparameters werefound betweentheclopidogreltreatmentgroupandticagrelor
treatmentgroup ( P >0.05 ) .NodifferencewasobservedoftroponinandPRUlevels24hbefore
PCI ( P >0.05 ) .TicagrelortreatmentremarkablyreducedthePRUandtroponinlevelsafterPCI
incomparisonwithclopidogreltreatmentgroup ( P <0.05 ) .Therateofpostoperativebleeding
wassimilarbetweenthetwogroups.However , theincidenceofmajoradversecardiovascular
events1yearafterPCIwassignificantlylowerintheticagrelorgroupcomparedtotheclopidogrel
group ( P <0.05 ) .Conclusion Modifyingantiplatelettreatmenttoticagrelorinhigh-riskcoronary
patientswithHTPRtoclopidogrelsignificantlyinhibitsplateletactivity , decreasestroponinlevel
andreducestheincidenceofadversecardiovasculareventsafter1yearsofPCI.

Key words: coronary disease； ticagrelor, platelet count