The Effectiveness And Safety Of Concomitant Ticagrelor Using With Fibrinolytic In ST-Elevation Myocardial Infarction Patients

Objective: The effectiveness and safety of administration ticagrelor simultaneously with fibrinolytic in STEMI remains unclear. Our study aims to compare and evaluate ticagrelor and clopidogrel in STEMI patients treated with fibrinolytics Material and Methods: The study consisted of 180 STEMI patients over 18 age who were given fibrinolytic therapy and had no absolute contraindications for treatment. Ticagrelor was given to 94 patients and clopidogrel was given to 86 patients. Loading doses were given to patients concurrently with fibrinolysis, followed by maintenance doses. The primary outcome was six-month follow-up for all-cause mortality, major cardiovascular events, stroke, recurrent MI, target vessel revascularization, and major bleeding. The secondary outcome was to evaluate patients over 75 years of age, use of rivaroxaban, and major adverse events that will develop in patients with chronic kidney disease. Results: There was no significant difference between the groups in terms of in-hospital death, GFR values (0.05). Mortality was observed in 5 of 86 patients using clopidogrel and in 4 of 94 patients using ticagrelor. (Log-rank test, p:0.63 HR=0.72 (95%CI, 0.19-2.67)). The BARC type 3-5 bleeding in patients using ticagrelor and clopidogrel were statistically similar. (Log-rank test, p:0.77 HR=1.23 (95%CI, 0.31 - 4.79)) Conclusions: In this study, we found the use of ticagrelor with fibrinolytic therapy was similar to clopidogrel in terms of effectiveness and safety.