Влияние тикагрелора и клопидогреля на ангиографические показатели в зависимости от статуса сахарного диабета у пациентов с инфарктом миокарда с подъемом сегмента ST

F. Aydınyılmaz; H. Sunman; E. Algül; А. Ö. İbiş; N. B. Özbeyaz; I. Guliyev; M. Erzurum; T. Çimen; M. Tulmaç

Статья

Влияние тикагрелора и клопидогреля на ангиографические показатели в зависимости от статуса сахарного диабета у пациентов с инфарктом миокарда с подъемом сегмента ST

F. Aydınyılmaz,

H. Sunman,

E. Algül,

А. Ö. İbiş, N. B. Özbeyaz,

I. Guliyev,

M. Erzurum,

T. Çimen, M. Tulmaç

2022

https://doi.org/10.15829/1560-4071-2022-5021

Цель. Сравнить результаты ангиографии при применении тикагрелора и клопидогрела в зависимости от уровня HbA1c у пациентов с инфарктом миокарда с подъемом сегмента ST.Материал и методы. Всего в исследование было включено 532 пациента, из них 334 получали тикагрелор (62,8%) и 198 − клопидогрел (37,2%). Статус сахарного диабета оценивался по уровню HbA1c. Степень кровотока (TIMI flow grade) и степень антеградного кровотока по количеству кадров (TIMI frame count, TFC) рассчитывали и сравнивали между двумя группами.Результаты. У пациентов, получавших тикагрелор, кровоток 3 степени по TIMI регистрировался чаще, а показатель TFC был меньше после чрескожного коронарного вмешательства на инфаркт-связанной артерии, по сравнению с клопидогрелом (89,2% vs 73,7%; p < 0,001, 20 vs 24; p< 0,001). Отмечена положительная корреляционная связь между повышением уровня HbA1c и TFC во всей группе (r=0,225; p=0,004). При анализе подгрупп более высокие уровни HbA1c не влияли на TFC у пациентов, принимавших тикагрелор (r=-0,060; p=0,326 для пациентов с феноменом отсутствия дистального коронарного кровотока (no-reflow), r=-0,133; p=0,321 для пациентов с кровотоком 3 степени по TIMI). В то время как уровень HbA1c не влиял на TFC у пациентов с кровотоком 3 степени по TIMI, наличие феномена no-reflow было связано с ухудшением TFC у пациентов, принимавших клопидогрел, по мере увеличения уровня HbA1c (r=0,374; p=0,005).Заключение. Было установлено, что прием тикагрелора связан с более благоприятными ангиографическими показателями независимо от сахарного диабета.

Aydınyılmaz F., Sunman H., Algül E., İbiş А. Ö., Özbeyaz N. B., Guliyev I., Erzurum M., Çimen T., Tulmaç M. Влияние тикагрелора и клопидогреля на ангиографические показатели в зависимости от статуса сахарного диабета у пациентов с инфарктом миокарда с подъемом сегмента ST. Российский кардиологический журнал. 2022;27(9):5021. https://doi.org/10.15829/1560-4071-2022-5021

Цитирование

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F. Aydınyılmaz
H. Sunman University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology
E. Algül University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology
А. Ö. İbiş University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology
N. B. Özbeyaz Cardiology clinics, Pursaklar State Hospital
I. Guliyev Cardiology clinics, Medical Park Hospital
M. Erzurum University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology
T. Çimen University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology
M. Tulmaç University of Health Sciences, Ankara Diskapi Training and Research Hospital, Cardiology

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Российский кардиологический журнал

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