Effects of Indobufen Combined with Clopidogrel on Left Ventricular Function and Inflammatory Factors in Patients after PCI

Authors

  • Rujia Wang Department of Pharmacy, Taizhou Central Hospital (Taizhou University Hospital), 317000 Taizhou, Zhejiang, China
  • Keke Wu Department of Emergency, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 317000 Taizhou, Zhejiang, China

DOI:

https://doi.org/10.59958/hsf.7721

Keywords:

indobufen, clopidogrel, PCI, left ventricular function, inflammatory factors

Abstract

Background: Percutaneous intracoronary intervention (PCI) is the preferred method for treating coronary heart disease. However, the insufficient coagulation function after the procedure may lead to poor vascular reperfusion, thereby affecting cardiac function. Indobufen and clopidogrel have antiplatelet and anti-inflammatory effects, but the impact of their combined use on left ventricular function and inflammatory factors in patients after PCI remains unclear. This study aimed to explore the influence of indobufen combined with clopidogrel on left ventricular function and inflammatory factors in patients after PCI. Methods: Medical records of 100 patients who underwent PCI surgery were selected for retrospective analysis. Their admission time ranged from January 2022 to June 2023. All research subjects who met the inclusion criteria were assigned to two groups according to different treatment methods with 57 cases in the control and 43 cases in the observation. The left ventricular function, inflammatory factors, coagulation function levels, and occurrence of complications were compared between the two groups. Results: After going through treatment, the levels of left ventricular end-diastolic volume, left ventricular end-systolic diameter, and left ventricular end-diastolic diameter of the observation group were significantly lower than those of the control. The ejection fraction significantly increased in the observation group, and the difference between two groups was significant (p < 0.05). Furthermore, the level of high-sensitivity C-reactive protein in the observation was significantly lower than that of the control benefiting from treatment with a significant difference (p < 0.05). The activated partial thromboplastin time, prothrombin time, and thrombin time levels of all patients significantly increased (p < 0.05) with no difference between the two groups (p > 0.05). The complication rate in the control patients was 17.54% (10/57), and that in the observation patients was 9.30% (4/43). No significant difference existed between the two groups (p > 0.05). Conclusions: Indobufen combined with clopidogrel treatment for patients after PCI significantly improved left ventricular function, inhibited inflammatory response, enhanced coagulation function, and had high safety. These results can provide some basis for the treatment of patients after clinical PCI.

References

Cybulska B, Kłosiewicz-Latoszek L. Landmark studies in coronary heart disease epidemiology. The Framingham Heart Study after 70 years and the Seven Countries Study after 60 years. Kardiologia Polska. 2019; 77: 173–180.

Duggan JP, Peters AS, Trachiotis GD, Antevil JL. Epidemiology of Coronary Artery Disease. The Surgical Clinics of North America. 2022; 102: 499–516.

Shawky A, Sabit H, Nazih M, Baraka K, El-Zawahry M. CYP2C19 Polymorphism in Ischemic Heart Disease Patients Taking Clopidogrel After Percutaneous Coronary Intervention in Egypt. Journal of Epidemiology and Global Health. 2023; 13: 374–383.

Shaya GE, Leucker TM, Jones SR, Martin SS, Toth PP. Coronary heart disease risk: Low-density lipoprotein and beyond. Trends in Cardiovascular Medicine. 2022; 32: 181–194.

Hoole SP, Bambrough P. Recent advances in percutaneous coronary intervention. Heart (British Cardiac Society). 2020; 106: 1380–1386.

Akbari T, Al-Lamee R. Percutaneous Coronary Intervention in Multi-Vessel Disease. Cardiovascular Revascularization Medicine: Including Molecular Interventions. 2022; 44: 80–91.

Voll F, Kuna C, Ndrepepa G, Kastrati A, Cassese S. Antithrombotic treatment in primary percutaneous coronary intervention. Expert Review of Cardiovascular Therapy. 2021; 19: 313–324.

Lopes RD, Heizer G, Aronson R, Vora AN, Massaro T, Mehran R, et al. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. The New England Journal of Medicine. 2019; 380: 1509–1524.

Kinlay S. Post-PCI Antithrombotic Treatment With High Bleeding Risk. Journal of the American College of Cardiology. 2022; 80: 1238–1240.

Wu H, Xu L, Zhao X, Zhang H, Cheng K, Wang X, et al. Indobufen or Aspirin on Top of Clopidogrel After Coronary Drug-Eluting Stent Implantation (OPTION): A Randomized, Open-Label, End Point-Blinded, Noninferiority Trial. Circulation. 2023; 147: 212–222.

Zhu T, Meng XB, Dong DX, Zhao LY, Qu MW, Sun GB, et al. Xuesaitong injection (lyophilized) combined with aspirin and clopidogrel protect against focal cerebral ischemic/reperfusion injury in rats by suppressing oxidative stress and inflammation and regulating the NOX2/IL-6/STAT3 pathway. Annals of Palliative Medicine. 2021; 10: 1650–1667.

Li J, Qiu H, Yan L, Guo T, Wang Y, Li Y, et al. Efficacy and Safety of Ticagrelor and Clopidogrel in Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention. Journal of Atherosclerosis and Thrombosis. 2021; 28: 873–882.

Shi QP, Luo XY, Zhang B, Wang XG, Zhao J, Xie QF, et al. Effect of indobufen vs. aspirin on platelet accumulation in patients with stable coronary heart disease after percutaneous coronary intervention: An open-label crossover study. Frontiers in Pharmacology. 2022; 13: 950719.

Luo J, le Cessie S, van Heemst D, Noordam R. Diet-Derived Circulating Antioxidants and Risk of Coronary Heart Disease: A Mendelian Randomization Study. Journal of the American College of Cardiology. 2021; 77: 45–54.

Simantiris S, Papastamos C, Antonopoulos AS, Theofilis P, Sagris M, Bounta M, et al. Oxidative Stress Biomarkers in Coronary Artery Disease. Current Topics in Medicinal Chemistry. 2023; 23: 2158–2171.

Lee SE, Lee HY, Cho HJ, Choe WS, Kim H, Choi JO, et al. Coronary artery bypass graft versus percutaneous coronary intervention in acute heart failure. Heart (British Cardiac Society). 2020; 106: 50–57.

Parikh PB, Bhatt DL, Bhasin V, Anker SD, Skopicki HA, Claessen BE, et al. Impact of Percutaneous Coronary Intervention on Outcomes in Patients with Heart Failure: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2021; 77: 2432–2447.

Yang J, Liu XK. Influence of bivalirudin combined nicorandil on cardiac ac function, coagulation function, and diagnosis ACS patients after PCI. Chinese Journal of Cardiovascular Rehabilitation Medicine. 2021; 30: 30–35. (In Chinese)

Sikora-Frac M, Zaborska B, Maciejewski P, Budaj A, Bednarz B. Improvement of left ventricular function after percutaneous coronary intervention in patients with stable coronary artery disease and preserved ejection fraction: Impact of diabetes mellitus. Cardiology Journal. 2021; 28: 923–931.

Pan Y, Meng X, Chen W, Jing J, Lin J, Jiang Y,et al. Indobufen versus aspirin in acute ischaemic stroke (INSURE): rationale and design of a multicentre randomised trial. Stroke and vascular neurology. 2022; 7: 457–461.

Xiong L, Zhang P. Effect of indobufen combined with ticagrelor on patients with acute ST-segment elevation myocardial infarction after PCI. Chinese Journal of Disaster Medicine. 2020; 8: 316–318. (In Chinese)

Aksoy F, Baş HA, Bağcı A, Savaş HB, Özaydın M. Predictive value of oxidative, antioxidative, and inflammatory status for left ventricular systolic recovery after percutaneous coronary intervention for ST-segment elevation myocardial infarction. Revista da Associacao Medica Brasileira (1992). 2022; 68: 1369–1375.

Bhat MA, Gandhi G. Elevated oxidative DNA damage in patients with coronary artery disease and its association with oxidative stress biomarkers. Acta Cardiologica. 2019; 74: 153–160.

Denegri A, Boriani G. High Sensitivity C-reactive Protein (hsCRP) and its Implications in Cardiovascular Outcomes. Current Pharmaceutical Design. 2021; 27: 263–275.

Göçer K, Aykan AÇ, Kılınç M, Göçer NS. Association of serum FGF-23, klotho, fetuin-A, osteopontin, osteoprotegerin and hs-CRP levels with coronary artery disease. Scandinavian Journal of Clinical and Laboratory Investigation. 2020; 80: 277–281.

Zheng YY, Wu TT, Yang Y, Hou XG, Gao Y, Chen Y, et al. Personalized antiplatelet therapy guided by a novel detection of platelet aggregation function in stable coronary artery disease patients undergoing percutaneous coronary intervention: a randomized controlled clinical trial. European Heart Journal. Cardiovascular Pharmacotherapy. 2020; 6: 211–221.

Song L, Zhao X, Chen R, Li J, Zhou J, Liu C, et al. Association of PCSK9 with inflammation and platelet activation markers and recurrent cardiovascular risks in STEMI patients undergoing primary PCI with or without diabetes. Cardiovascular Diabetology. 2022; 21: 80.

Angiolillo DJ, Galli M, Collet JP, Kastrati A, O'Donoghue ML. Antiplatelet therapy after percutaneous coronary intervention. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2022; 17: e1371–e1396.

Jia D, Wei X, Qin B, Huang J. The effect of bivalirudin on coagulation function in male patients with coronary heart disease undergoing percutaneous coronary intervention. Pakistan Journal of Pharmaceutical Sciences. 2023; 36: 1089–1092.

Published

2024-09-10

How to Cite

Wang, R., & Wu, K. (2024). Effects of Indobufen Combined with Clopidogrel on Left Ventricular Function and Inflammatory Factors in Patients after PCI. The Heart Surgery Forum, 27(9), E1010-E1016. https://doi.org/10.59958/hsf.7721

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Article