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The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel

BACKGROUND/AIMS: Coronary endothelial and microvascular function play important roles in cardiovascular disease. We aimed to evaluate the effect of ticagrelor on coronary artery function and tested the antiplatelet effect of low dose ticagrelor in East-Asian patients. METHODS: Sixty-one consecutive...

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Autores principales: Choi, Woong Gil, Kim, Gi Chang, Lee, Cheol Ho, Kim, Hye Young, Kim, Dong Woon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969081/
https://www.ncbi.nlm.nih.gov/pubmed/32564571
http://dx.doi.org/10.3904/kjim.2019.293
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author Choi, Woong Gil
Kim, Gi Chang
Lee, Cheol Ho
Kim, Hye Young
Kim, Dong Woon
author_facet Choi, Woong Gil
Kim, Gi Chang
Lee, Cheol Ho
Kim, Hye Young
Kim, Dong Woon
author_sort Choi, Woong Gil
collection PubMed
description BACKGROUND/AIMS: Coronary endothelial and microvascular function play important roles in cardiovascular disease. We aimed to evaluate the effect of ticagrelor on coronary artery function and tested the antiplatelet effect of low dose ticagrelor in East-Asian patients. METHODS: Sixty-one consecutive patients with non-significant coronary disease were included in the study. Initially, patients were randomized in 1:1:1 ratio to receive drugs: ticagrelor 90 mg twice a day (bid; n = 22), ticagrelor 45 mg bid (n = 19) or clopidogrel 75 mg once a day (qd; n = 20) and then divided into two groups (ticagrelor vs clopidogrel) for evaluation of coronary artery function, and three groups for evaluation of antiplatelet function. Endothelial dysfunction was measured by coronary flow reserve (CFR), and changes in the levels of asymmetric dimethylarginine (ADMA), cluster of differentiation (CD) 40 ligand, and P-selectin. Microvascular function was evaluated as index of microvascular resistance (IMR). Platelet reactivity was assessed by VerifyNow P2Y12 assay. RESULTS: The levels of CFR, ADMA, and CD 40 ligand were not different between the two groups. However, P-selectin was lower in the ticagrelor group compared with clopidogrel group. IMR was significantly lower in the ticagrelor group compared with clopidogrel group (median, 15.0 [interquartile range, 12.0 to 21.0] vs. 47.5 [23.0 to 67.5], p = 0.014). There was significant difference in platelet inhibition among the three groups (ticagrelor 90 mg bid vs. ticagrelor 45 mg bid vs. clopidogrel 75 mg qd; 85.57 ± 47.63 vs. 120.33 ± 51.09 vs. 256.42 ± 55.10, p < 0.001) CONCLUSIONS: It is hypothesized that ticagrelor might ameliorate the coronary microvascular function. When compared with clopidogrel, low dose ticagrelor exhibited satisfactory antiplatelet effect in the present study.
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spelling pubmed-79690812021-04-01 The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel Choi, Woong Gil Kim, Gi Chang Lee, Cheol Ho Kim, Hye Young Kim, Dong Woon Korean J Intern Med Original Article BACKGROUND/AIMS: Coronary endothelial and microvascular function play important roles in cardiovascular disease. We aimed to evaluate the effect of ticagrelor on coronary artery function and tested the antiplatelet effect of low dose ticagrelor in East-Asian patients. METHODS: Sixty-one consecutive patients with non-significant coronary disease were included in the study. Initially, patients were randomized in 1:1:1 ratio to receive drugs: ticagrelor 90 mg twice a day (bid; n = 22), ticagrelor 45 mg bid (n = 19) or clopidogrel 75 mg once a day (qd; n = 20) and then divided into two groups (ticagrelor vs clopidogrel) for evaluation of coronary artery function, and three groups for evaluation of antiplatelet function. Endothelial dysfunction was measured by coronary flow reserve (CFR), and changes in the levels of asymmetric dimethylarginine (ADMA), cluster of differentiation (CD) 40 ligand, and P-selectin. Microvascular function was evaluated as index of microvascular resistance (IMR). Platelet reactivity was assessed by VerifyNow P2Y12 assay. RESULTS: The levels of CFR, ADMA, and CD 40 ligand were not different between the two groups. However, P-selectin was lower in the ticagrelor group compared with clopidogrel group. IMR was significantly lower in the ticagrelor group compared with clopidogrel group (median, 15.0 [interquartile range, 12.0 to 21.0] vs. 47.5 [23.0 to 67.5], p = 0.014). There was significant difference in platelet inhibition among the three groups (ticagrelor 90 mg bid vs. ticagrelor 45 mg bid vs. clopidogrel 75 mg qd; 85.57 ± 47.63 vs. 120.33 ± 51.09 vs. 256.42 ± 55.10, p < 0.001) CONCLUSIONS: It is hypothesized that ticagrelor might ameliorate the coronary microvascular function. When compared with clopidogrel, low dose ticagrelor exhibited satisfactory antiplatelet effect in the present study. The Korean Association of Internal Medicine 2021-03 2020-06-23 /pmc/articles/PMC7969081/ /pubmed/32564571 http://dx.doi.org/10.3904/kjim.2019.293 Text en Copyright © 2021 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Woong Gil
Kim, Gi Chang
Lee, Cheol Ho
Kim, Hye Young
Kim, Dong Woon
The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title_full The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title_fullStr The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title_full_unstemmed The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title_short The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
title_sort effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969081/
https://www.ncbi.nlm.nih.gov/pubmed/32564571
http://dx.doi.org/10.3904/kjim.2019.293
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