Comparison of Clopidogrel and Ticagrelor on Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction

Phase 4CompletedNCT02026219

Inha University Hospital76 enrolled

Overview

Ticagrelor is a non-thienophyridine, direct P2Y12 blocker that is more potent than clopidogrel and is associated with less interindividual variability. In the PLATO trial, it was found to be superior to clopidogrel with respect to cardiovascular outcomes and total mortality without increasing the risk of bleedings. More potent and reversible receptor bindings are possible explanation for the superior outcomes. Beside the potent effect on inhibition of antiplatelet function, ticagrelor has previously been demonstrated to increase adenosine levels by inhibiting adenosine re-uptake in tissue level and can induce adenosine triphosphate (ATP) release from human red cells, which both stimulate vasodilation of in red blood cells.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Non-ST Segment Elevation Myocardial Infarction ST Segment Elevation Myocardial Infarction

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

* Inclusion Criteria: * Males and Females * between the ages of 18 and 75 years * STEMI patients treated with percutaneous coronary intervention * Able to provide informed consent * Exclusion Criteria: * History of stroke or transient ischemic attack * Platelet count \< 100 000/μL * Known Bleeding Diathesis * Hematocrit \<30% or \>52% * Severe Liver Dysfunction * Renal Insufficiency (Creatinine Clearance \< 30ml/min) * Pregnant females * Cardiogenic shock or symptomatic hypotension or sitting SBP \< 95 mmHg

Outcomes

Primary Outcomes

Index of microcirculatory resistance (IMR) measured after successful coronary intervention

Time frame: IMR will be immediately assessed after successful PCI patients within 48hr from admission

Secondary Outcomes

wall motion score index on three month later TTE from index PCI

Time frame: TTE will be assessed in all enrolled patients 3 month later from index PCI