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Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease

BACKGROUND: We compared the acute and midterm effect of ticagrelor versus clopidogrel on aortic stiffness. METHODS AND RESULTS: We studied 117 patients in a randomized, assessor‐blinded, parallel‐group trial. The acute effect of ticagrelor was studied in 58 patients randomized (1:1) to receive a loa...

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Autores principales: Vlachopoulos, Charalambos, Georgakopoulos, Christos, Pietri, Panagiota, Ioakeimidis, Nikolaos, Koutouzis, Michael, Vaina, Sophia, Aznaouridis, Konstantinos, Toutouzas, Konstantinos, Latsios, George, Terentes‐Printzios, Dimitrios, Rigatou, Aggeliki, Tousoulis, Dimitris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6645640/
https://www.ncbi.nlm.nih.gov/pubmed/31165663
http://dx.doi.org/10.1161/JAHA.119.012521
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author Vlachopoulos, Charalambos
Georgakopoulos, Christos
Pietri, Panagiota
Ioakeimidis, Nikolaos
Koutouzis, Michael
Vaina, Sophia
Aznaouridis, Konstantinos
Toutouzas, Konstantinos
Latsios, George
Terentes‐Printzios, Dimitrios
Rigatou, Aggeliki
Tousoulis, Dimitris
author_facet Vlachopoulos, Charalambos
Georgakopoulos, Christos
Pietri, Panagiota
Ioakeimidis, Nikolaos
Koutouzis, Michael
Vaina, Sophia
Aznaouridis, Konstantinos
Toutouzas, Konstantinos
Latsios, George
Terentes‐Printzios, Dimitrios
Rigatou, Aggeliki
Tousoulis, Dimitris
author_sort Vlachopoulos, Charalambos
collection PubMed
description BACKGROUND: We compared the acute and midterm effect of ticagrelor versus clopidogrel on aortic stiffness. METHODS AND RESULTS: We studied 117 patients in a randomized, assessor‐blinded, parallel‐group trial. The acute effect of ticagrelor was studied in 58 patients randomized (1:1) to receive a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg). Carotid‐femoral pulse wave velocity (cfPWV) was measured before, 3, and 24 hours after the loading dose. The midterm effect (30‐day treatment period) was studied in 59 subjects who underwent percutaneous coronary intervention and were randomized to either clopidogrel (75 mg, OD) or ticagrelor (90 mg BID). cfPWV was measured before and at 30 days of treatment. Circulating markers of inflammation and endothelial function were measured at all study points. Repeated‐measures analysis showed a significant main effect for treatment (P=0.03), with the ticagrelor showing a reduction in cfPWV after treatment. cfPWV at 24 hours was significantly lower in the ticagrelor group compared with the clopidogrel group (P=0.017) (maximal response reduction by 0.42±0.26 m/s). At 30 days, cfPWV decreased in the ticagrelor group, whereas there was no change with clopidogrel (−0.43±0.57 versus 0.12±0.14 m/s, P=0.004). There were no significant changes in both the acute and midterm study period in the pro‐inflammatory and endothelial function parameters. CONCLUSIONS: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02071212. Ticagrelor decreases cfPWV for 24 hours after the loading dose and at 1 month post–percutaneous coronary intervention compared with clopidogrel. Considering that aortic stiffness is an independent predictor of cardiovascular events, this finding may have clinical implications regarding the beneficial effect of ticagrelor. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02071212.
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spelling pubmed-66456402019-07-31 Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease Vlachopoulos, Charalambos Georgakopoulos, Christos Pietri, Panagiota Ioakeimidis, Nikolaos Koutouzis, Michael Vaina, Sophia Aznaouridis, Konstantinos Toutouzas, Konstantinos Latsios, George Terentes‐Printzios, Dimitrios Rigatou, Aggeliki Tousoulis, Dimitris J Am Heart Assoc Original Research BACKGROUND: We compared the acute and midterm effect of ticagrelor versus clopidogrel on aortic stiffness. METHODS AND RESULTS: We studied 117 patients in a randomized, assessor‐blinded, parallel‐group trial. The acute effect of ticagrelor was studied in 58 patients randomized (1:1) to receive a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg). Carotid‐femoral pulse wave velocity (cfPWV) was measured before, 3, and 24 hours after the loading dose. The midterm effect (30‐day treatment period) was studied in 59 subjects who underwent percutaneous coronary intervention and were randomized to either clopidogrel (75 mg, OD) or ticagrelor (90 mg BID). cfPWV was measured before and at 30 days of treatment. Circulating markers of inflammation and endothelial function were measured at all study points. Repeated‐measures analysis showed a significant main effect for treatment (P=0.03), with the ticagrelor showing a reduction in cfPWV after treatment. cfPWV at 24 hours was significantly lower in the ticagrelor group compared with the clopidogrel group (P=0.017) (maximal response reduction by 0.42±0.26 m/s). At 30 days, cfPWV decreased in the ticagrelor group, whereas there was no change with clopidogrel (−0.43±0.57 versus 0.12±0.14 m/s, P=0.004). There were no significant changes in both the acute and midterm study period in the pro‐inflammatory and endothelial function parameters. CONCLUSIONS: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02071212. Ticagrelor decreases cfPWV for 24 hours after the loading dose and at 1 month post–percutaneous coronary intervention compared with clopidogrel. Considering that aortic stiffness is an independent predictor of cardiovascular events, this finding may have clinical implications regarding the beneficial effect of ticagrelor. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02071212. John Wiley and Sons Inc. 2019-06-05 /pmc/articles/PMC6645640/ /pubmed/31165663 http://dx.doi.org/10.1161/JAHA.119.012521 Text en © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Vlachopoulos, Charalambos
Georgakopoulos, Christos
Pietri, Panagiota
Ioakeimidis, Nikolaos
Koutouzis, Michael
Vaina, Sophia
Aznaouridis, Konstantinos
Toutouzas, Konstantinos
Latsios, George
Terentes‐Printzios, Dimitrios
Rigatou, Aggeliki
Tousoulis, Dimitris
Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title_full Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title_fullStr Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title_full_unstemmed Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title_short Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease
title_sort effect of ticagrelor versus clopidogrel on aortic stiffness in patients with coronary artery disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6645640/
https://www.ncbi.nlm.nih.gov/pubmed/31165663
http://dx.doi.org/10.1161/JAHA.119.012521
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