Ticagrelor: Yet Another Pleiotropic Effect?

Studies in animals have shown ticagrelor offers better myocardial protection against reperfusion injury after ST elevation MI than clopidogrel. 

ticagrelor_enfermedad_vascular_periférica

This had to be tested in the clinical arena, which is the aim of this study (published in JACC Intv): to assess left ventricular remodeling after reperfusion. 

The study included patients undergoing their first ST elevation MI. These patients were treated successfully with primary PCI and dual antiaggregation therapy for at least 6 months. 

Final end points were left ventricular remodeling index (relative change of end diastolic volume) measured by 3D echocardiography and N-terminal pro-B-type natriuretic peptide levelat 6 months. 

139 patients were randomized to DAPT with ticagrelor and the same number of patients to DAPT with clopidogrel. 


Read also: Safety and Efficacy of the Pfizer-BioNTech Vaccine Against COVID-19.


At 6-month followup, remodeling was numerically lower with ticagrelor vs clopidogrel, but NT pro-BNP levels resulted significantly lower with the first (173 ± 141 pg/ml vs. 289 ± 585 pg/ml; p=0.028).

These differences resulted more significative in patients with pre-PCI TIMI flow grade 0.

End diastolic volume showed no changes during treatment with ticagrelor but increased in 2.3 ml/m2 in patients receiving clopidogrel. 


Read also: Efficacy of the Moderna COVID-19 Vaccine.


This difference was more significative when looking at end diastolic volume. 

Conclusion

Ticagrelor resulted superior to clopidogrel in terms of ventricular remodeling after successful reperfusion for ST elevation MI. 

Original Title: Effect of Ticagrelor on Left Ventricular Remodeling in Patients With ST-Segment Elevation Myocardial Infarction (HEALING-AMI).

Reference: Yongwhi Park et al. J Am Coll Cardiol Intv 2020;13:2220–34https://doi.org/10.1016/j.jcin.2020.08.007.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

TCT 2024 | Use of Drug-Coated Balloons for Side Branch Treatment in Provisional Stenting

In some cases, treating coronary bifurcations with provisional stenting requires side branch stenting, which may lead to suboptimal outcomes. Drug-coated balloons (DCBs) have emerged...

TCT 2024 | Use of Artificial Intelligence for Patients with Suspected Coronary Artery Disease

The current approach to chest pain mainly focuses on symptom characteristics, conducting functional tests for ischemia assessment. However, several randomized clinical trials have shown...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...