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TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial

Background: Because rotational atherectomy (RA) is associated with arterial trauma and platelet activation, patients treated with RA may benefit from more potent antiplatelet drugs. The aim of this trial was to assess the superiority of ticagrelor over clopidogrel in reducing post procedure troponin...

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Autores principales: Lhermusier, Thibault, Motreff, Pascal, Bataille, Vincent, Cayla, Guillaume, Farah, Bruno, Roncalli, Jerome, Elbaz, Meyer, Boudou, Nicolas, Campello-Parada, Fransisco, Bouisset, Frederic, Souteyrand, Geraud, Berard, Emilie, Bongard, Vanina, Carrie, Didier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964861/
https://www.ncbi.nlm.nih.gov/pubmed/36835980
http://dx.doi.org/10.3390/jcm12041445
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author Lhermusier, Thibault
Motreff, Pascal
Bataille, Vincent
Cayla, Guillaume
Farah, Bruno
Roncalli, Jerome
Elbaz, Meyer
Boudou, Nicolas
Campello-Parada, Fransisco
Bouisset, Frederic
Souteyrand, Geraud
Berard, Emilie
Bongard, Vanina
Carrie, Didier
author_facet Lhermusier, Thibault
Motreff, Pascal
Bataille, Vincent
Cayla, Guillaume
Farah, Bruno
Roncalli, Jerome
Elbaz, Meyer
Boudou, Nicolas
Campello-Parada, Fransisco
Bouisset, Frederic
Souteyrand, Geraud
Berard, Emilie
Bongard, Vanina
Carrie, Didier
author_sort Lhermusier, Thibault
collection PubMed
description Background: Because rotational atherectomy (RA) is associated with arterial trauma and platelet activation, patients treated with RA may benefit from more potent antiplatelet drugs. The aim of this trial was to assess the superiority of ticagrelor over clopidogrel in reducing post procedure troponin release. Methods: TIRATROP (TIcagrelor in Rotational Atherectomy to reduce TROPonin enhancement) is a multicenter double-blind randomized controlled trial that included 180 patients with severe calcified lesions requiring RA who received either clopidogrel (300 mg loading dose, then 75 mg/d) or ticagrelor (loading dose 180 mg then 90 mg twice daily). Blood samples were collected at the beginning (T0), and 6, 12, 18, 24 and 36 h after the procedure. Primary end point was troponin release within the first 24 h using area under the curve analysis (troponin level as a function of time). Results: The mean age of patients was 76 ± 10 years, 35% had diabetes. RA was used to treat 1, 2 or 3 calcified lesions in 72%, 23% and 5% of patients, respectively. Troponin release within the first 24 h was similar in both the ticagrelor (adjusted mean ±SD of ln AUC 8.85 ± 0.33) and the clopidogrel (8.77 ± 0.34, p = 0.60) arms. Independent predictors for troponin enhancement were acute coronary syndrome presentation, renal failure, elevated C-Reactive protein and multiple lesions treated with RA. Conclusion: Troponin release did not differ among treatment arms. Our results suggest that greater platelet inhibition does not affect periprocedural myocardial necrosis in the setting of RA.
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spelling pubmed-99648612023-02-26 TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial Lhermusier, Thibault Motreff, Pascal Bataille, Vincent Cayla, Guillaume Farah, Bruno Roncalli, Jerome Elbaz, Meyer Boudou, Nicolas Campello-Parada, Fransisco Bouisset, Frederic Souteyrand, Geraud Berard, Emilie Bongard, Vanina Carrie, Didier J Clin Med Article Background: Because rotational atherectomy (RA) is associated with arterial trauma and platelet activation, patients treated with RA may benefit from more potent antiplatelet drugs. The aim of this trial was to assess the superiority of ticagrelor over clopidogrel in reducing post procedure troponin release. Methods: TIRATROP (TIcagrelor in Rotational Atherectomy to reduce TROPonin enhancement) is a multicenter double-blind randomized controlled trial that included 180 patients with severe calcified lesions requiring RA who received either clopidogrel (300 mg loading dose, then 75 mg/d) or ticagrelor (loading dose 180 mg then 90 mg twice daily). Blood samples were collected at the beginning (T0), and 6, 12, 18, 24 and 36 h after the procedure. Primary end point was troponin release within the first 24 h using area under the curve analysis (troponin level as a function of time). Results: The mean age of patients was 76 ± 10 years, 35% had diabetes. RA was used to treat 1, 2 or 3 calcified lesions in 72%, 23% and 5% of patients, respectively. Troponin release within the first 24 h was similar in both the ticagrelor (adjusted mean ±SD of ln AUC 8.85 ± 0.33) and the clopidogrel (8.77 ± 0.34, p = 0.60) arms. Independent predictors for troponin enhancement were acute coronary syndrome presentation, renal failure, elevated C-Reactive protein and multiple lesions treated with RA. Conclusion: Troponin release did not differ among treatment arms. Our results suggest that greater platelet inhibition does not affect periprocedural myocardial necrosis in the setting of RA. MDPI 2023-02-11 /pmc/articles/PMC9964861/ /pubmed/36835980 http://dx.doi.org/10.3390/jcm12041445 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lhermusier, Thibault
Motreff, Pascal
Bataille, Vincent
Cayla, Guillaume
Farah, Bruno
Roncalli, Jerome
Elbaz, Meyer
Boudou, Nicolas
Campello-Parada, Fransisco
Bouisset, Frederic
Souteyrand, Geraud
Berard, Emilie
Bongard, Vanina
Carrie, Didier
TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title_full TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title_fullStr TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title_full_unstemmed TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title_short TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: The TIRATROP Study, A Randomized Controlled Trial
title_sort ticagrelor in rotational atherectomy to reduce troponin enhancement: the tiratrop study, a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964861/
https://www.ncbi.nlm.nih.gov/pubmed/36835980
http://dx.doi.org/10.3390/jcm12041445
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