Effects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary intervention
Authors' conclusion
In patients with stable CAD undergoing PCI, pretreatment with a loading dose of ticagrelor compared with prasugrel improves post-procedural coronary flow and microvascular function and seems to reduce the related myocardial injury.
Study context
- Population
- Patients with stable coronary artery disease (CAD) treated with elective percutaneous coronary intervention (PCI)
- Participants
- 50 patients
- Comparison
- Ticagrelor vs prasugrel loading dose before elective PCI
- Primary endpoint
- Absolute coronary blood flow (Q) and microvascular resistance (R) by continuous thermodilution
- Follow-up
- After PCI
Primary result
As reported in the abstract
Post-PCI Q and R
| Group | Value | R |
|---|---|---|
| Ticagrelor | 242 ± 49 mL/min | 311 (263, 366) mm Hg/L/min |
| Prasugrel | 205 ± 53 mL/min | 362 (319, 382) mm Hg/L/min |
Value
Ticagrelor242 ± 49 mL/min
Prasugrel205 ± 53 mL/min
R
Ticagrelor311 (263, 366) mm Hg/L/min
Prasugrel362 (319, 382) mm Hg/L/min
- Ticagrelor vs Prasugrel: P = 0.015 — higher post-PCI Q
- Ticagrelor vs Prasugrel: P = 0.032 — lower post-PCI R
Further findings
Periprocedural increase in high-sensitivity troponin I · significantly lower with ticagrelor
P < 0.001
Correlation of platelet reactivity with periprocedural variation of Q and R
- Negative correlation with Q variation
- r=−0.582, p<0.001
- Positive correlation with R variation
- r=0.645, p<0.001
Original publication
Effects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary intervention. Heart. Published 14 June 2023. doi:10.
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