Therapeutic Effects of Triple Antiplatelet Therapy in Elderly Female Patients with Diabetes and Acute Myocardial Infarction

Combined use of anti-platelet aggregation drugs and shujin huoluo decoction for diabetic peripheral vascular disease: enhanced therapeutic efficacy

OBJECTIVE

To investigate the clinical effect of anti-platelet aggregation drugs combined with Shujin Huoluo Decoction (SJHLD, a decoction for relaxing muscles and activating collaterals) in the treatment of diabetic peripheral vascular disease.

METHODS

A total of 130 patients with diabetic peripheral vascular disease were retrospectively included in this study and divided into two groups. In the monotherapy group, 65 patients were treated with cilostazol (CTZ) monotherapy; in the combined group, 65 patients were treated with CTZ combined with SJHLD. The treatment efficacy, inflammatory indexes, blood glucose and lipid levels, ultrasound parameters, and hemorheology of the two groups were compared before and after treatment.

RESULTS

Both groups showed significant improvements in walking distance and skin temperature of the toes, with more pronounced changes observed in the combined group (P < 0.05). After treatment, inflammatory markers decreased notably in both groups (P < 0.05). Blood glucose and lipid levels decreased markedly, with a more substantial reduction in lipid levels observed in the combined group (P < 0.05). Lower limb arterial conditions improved markedly in both groups, with greater improvements seen in the combined group (P < 0.05). Additionally, the pulsatile index and blood flow velocity in the ankle-brachial and dorsalis pedis arteries increased markedly in both groups, with the combined group showing a greater improvement (P < 0.05). Hemorheology parameters also decreased significantly in both groups, with the combined group showing a more significant reduction (P < 0.05). The effective treatment rate was significantly higher in the combined group (P < 0.05).

CONCLUSIONS

The combination of CTZ and SJHLD significantly improves lower limb function, ultrasound parameters, and blood flow, enhancing treatment efficiency in patients with diabetic peripheral vascular disease. This therapeutic approach offers valuable clinical guidance and warrants consideration for use in diabetic patients.

Effects of different doses of tirofiban combined with dual antiplatelet drugs on platelet indices, vascular endothelial function, and major adverse cardiovascular events in patients with acute ST-segment elevated myocardial infarction undergoing percutaneous coronary intervention

This trial targeted to analyze the effects of different doses of tirofiban combined with dual antiplatelet drugs on platelet indices, vascular endothelial function, and major adverse cardiovascular events (MACE) in patients with acute ST-segment elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). A total of 180 patients with STEMI who underwent PCI were divided into Group A, Group B, and Group C (60 cases per group). Group A was given conventional medication, and Groups B and C were given a standard dose (10 μg/kg) and a high dose (20 μg/kg) of tirofiban on the basis of Group A, respectively. Thrombolysis in myocardial infarction (TIMI) myocardial perfusion grade and TIMI blood flow grade were compared. Myocardial enzymes, platelet indices, vascular endothelial function, inflammatory factors, and cardiac function indices were detected. In-hospital bleeding events and follow-up MACE were recorded. After PCI, Group C had a higher number of TIMI myocardial perfusion grade III and TIMI blood flow grade III versus Group A. Group C achieved the greatest changes in myocardial enzymes, platelet indices, vascular endothelial function-related factors, inflammatory factors, and cardiac function indices, followed by Group B and Group A. The incidence of bleeding events was higher in Group C than in Group A, and that of MACE in Group C was lower than in Group A. The addition of high-dose tirofiban to PCI and dual antiplatelet drugs for STEMI patients can improve myocardial blood perfusion, cardiac function, and vascular endothelial function, inhibit platelet activation and aggregation, and reduce the occurrence of MACE.

The Clinical Efficacy of Tirofiban Combined with Ticagrelor and Aspirin in Treating Acute Myocardial Infarction by Percutaneous Coronary Intervention and Its Effect on Patients' Cardiac Function

OBJECTIVE

To explore the clinical efficacy of tirofiban combined with ticagrelor and aspirin in acute myocardial infarction treatment by percutaneous coronary intervention and its effect on patients' cardiac function.

METHODS

We selected 102 patients with acute myocardial infarction who came to The First Hospital of LanZhou University for treatment from July 2018 to May 2021. On the basis of conventional treatment, patients were separated into a joint group (tirofiban combined with ticagrelor and aspirin) comprising 55 cases and a control group (conventional ticagrelor and aspirin dual treatment) involving 47 cases. Blood flow classification of the two groups of patients was immediately recorded and compared after the myocardial infarction thrombolysis test (TIMI). Left ventricular function-related indicators, platelet-related parameters, neutrophil/lymphocyte ratio (NLR), red blood cell distribution width (RDW), and platelet/lymphocyte ratio (PLR) before treatment and 7 days after PCI were evaluated and compared between the groups before treatment and 3 months after treatment. ELISA was utilized to detect the serum levels of inflammatory factors, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and hypersensitive C-reactive protein (hs-CRP) before and after treatment. Incidence of major adverse cardiovascular events (MACEs) and adverse reaction incidence was put into comparison between the two groups in the course of the 3-month follow-up period. Compared with the control group, the joint group accounted for more patients with TIMI blood flow classification level 3 (P < 0.05) and showed more drastic improvement on the left ventricular function, platelet-related parameters, and serum inflammatory factors (P < 0.05). Moreover, patients of the joint group suffered less fluctuation from RDW, NLR, and PLR (P < 0.05), and their incidence of MACE was drastically lower in contrast with the control group (P < 0.05). No notable changes were presented in terms of incidence of adverse reaction (P > 0.05). For patients who suffered from acute myocardial infarction and treated with percutaneous coronary intervention, the application of tirofiban combined with ticagrelor and aspirin could effectively reduce the incidence of no reflow or slow blood flow, improve myocardial perfusion function, and have marked curative effects. It is worthy of clinical promotion and application.