Pretreatment with ticagrelor reduces troponin levels in stable CAD patients undergoing PCI

For this purpose, 50 patients were randomly assigned to ticagrelor (180 mg) or prasugrel (60 mg) at least 12 hours before the intervention. Continuous thermodilution was used for Q and R measures before and after PCI. Before PCI, platelet reactivity was measured. Troponin I was measured before, 8 and 24 hours after PCI.

The authors revealed the following findings:

• At baseline, fractional flow reserve, Q and R were similar in the two study groups.
• Patients in the ticagrelor group showed higher post-PCI Q (242±49 versus 205±53 mL/min) and lower R values (311 versus 362 mm Hg/L/min).
• Platelet reactivity showed a negative correlation with a periprocedural variation of Q values (r=−0.582) and a positive correlation with a periprocedural variation of R values (r=0.645).
• The periprocedural increase in high-sensitivity troponin I was significantly lower in the ticagrelor compared with the prasugrel group (5 ng/mL vs 14 ng/mL).

"Our findings suggest that pretreatment with a loading dose of ticagrelor compared with prasugrel improves post-procedural coronary flow and microvascular function and reduces the related myocardial injury in patients with stable CAD undergoing PCI," the researchers concluded.

Reference:

Mangiacapra F, Colaiori I, Di Gioia G, et alEffects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary interventionHeart Published Online First: 14 June 2023. doi: 10.1136/heartjnl-2022-321868