期刊
BASIC RESEARCH IN CARDIOLOGY
卷 116, 期 1, 页码 -出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s00395-021-00870-y
关键词
P2Y(12) inhibitor; Cardioprotection; Ischemic conditioning; Myocardial infarction
资金
- British Heart Foundation Clinical Study Grant [CS/14/3/31002]
- University College London Hospital/University College London Biomedical Research Clinical Research grant
- Danish Innovation Foundation [11-108354, 11-115818]
- Novo Nordisk Foundation [NNF13OC0007447]
- Trygfonden [109624]
- British Heart Foundation [FS/10/039/28270]
- Singapore Ministry of Health's National Medical Research Council [NMRC/CSA-SI/0011/2017, NMRC/CGAug16C006]
- COST (European Cooperation in Science and Technology)
- COST Action EU-CARDIOPROTECTION [CA16225]
- Duke-National University Singapore Medical School
The study explored the translational cardioprotective potential of P2Y(12) inhibitors in acute myocardial ischemia/reperfusion injury, showing that ticagrelor may have better effects in reducing infarct size.
We studied the translational cardioprotective potential of P2Y(12) inhibitors against acute myocardial ischemia/reperfusion injury (IRI) in an animal model of acute myocardial infarction and in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). P2Y(12) inhibitors may have pleiotropic effects to induce cardioprotection against acute myocardial IRI beyond their inhibitory effects on platelet aggregation. We compared the cardioprotective effects of clopidogrel, prasugrel, and ticagrelor on infarct size in an in vivo rat model of acute myocardial IRI, and investigated the effects of the P2Y(12) inhibitors on enzymatic infarct size (48-h area-under-the-curve (AUC) troponin T release) and clinical outcomes in a retrospective study of STEMI patients from the CONDI-2/ERIC-PPCI trial using propensity score analyses. Loading with ticagrelor in rats reduced infarct size after acute myocardial IRI compared to controls (37 +/- 11% vs 52 +/- 8%, p < 0.01), whereas clopidogrel and prasugrel did not (50 +/- 11%, p > 0.99 and 49 +/- 9%, p > 0.99, respectively). Correspondingly, troponin release was reduced in STEMI patients treated with ticagrelor compared to clopidogrel (adjusted 48-h AUC ratio: 0.67, 95% CI 0.47-0.94). Compared to clopidogrel, the composite endpoint of cardiac death or hospitalization for heart failure within 12 months was reduced in STEMI patients loaded with ticagrelor (HR 0.63; 95% CI 0.42-0.94) but not prasugrel (HR 0.84, 95% CI 0.43-1.63), prior to PPCI. Major adverse cardiovascular events did not differ between clopidogrel, ticagrelor, or prasugrel. The cardioprotective effects of ticagrelor in reducing infarct size may contribute to the clinical benefit observed in STEMI patients undergoing PPCI.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据