Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome

Ya Ru Zhang; Zheng Kai Xue; Kang Yin Chen; Ling Xia Xu; Wei Ding Wang; Hua Yue Tao; Tong Liu; Jing Jin Che; Xue Wen Wang; Seung Woon Rha; Jia Rui Wang; Peng Wang

doi:10.1177/0267659120927857

Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome

Ya Ru Zhang, Zheng Kai Xue, Kang Yin Chen, Ling Xia Xu, Wei Ding Wang, Hua Yue Tao, Tong Liu, Jing Jin Che, Xue Wen Wang, Seung Woon Rha, Jia Rui Wang, Peng Wang

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background: Periprocedural myocardial infarction is a common complication following percutaneous coronary intervention. The present study was conducted with an aim to compare the safety and efficacy of loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. Methods: A total of 114 patients with acute coronary syndrome undergoing elective percutaneous coronary intervention were assigned to clopidogrel group (n = 57, the loading and maintenance doses were 300 and 75 mg qd for clopidogrel, and 300 and 100 mg qd for aspirin), or ticagrelor group (n = 57, the loading and maintenance doses were 180 and 90 mg bid for ticagrelor, and 300 and 100 mg qd for aspirin). Cardiac biomarkers were measured before, 8 hours, and 24 hours after percutaneous coronary intervention. The percutaneous coronary intervention–related periprocedural myocardial infarction was defined according to the fourth universal definition of myocardial infarction (2018). Results: The overall incidence of percutaneous coronary intervention–related periprocedural myocardial infarction was 21.1%. The ticagrelor group showed a significantly lower incidence of periprocedural myocardial infarction (12.3% vs 29.8%, p = 0.022) and numerically lower bleeding events (3.5% vs 8.8%, p = 0.242) as compared with clopidogrel group. No patient had major adverse cardiovascular events during the 1-month follow-up. The levels of high-sensitivity C-reactive protein did not differ significantly between the two groups (p > 0.05), indicating that the benefits of ticagrelor were not from its anti-inflammatory effects. Multivariable analysis showed that the use of ticagrelor (odds ratio: 0.50; 95% confidence interval: 0.29-0.87; p = 0.014) and number of stents (odds ratio: 2.75; 95% confidence interval: 1.25-6.06; p = 0.012) were independent predictors of periprocedural myocardial infarction. Conclusion: Pretreatment with a loading dose of ticagrelor seems to be superior in reducing the incidence of percutaneous coronary intervention–related periprocedural myocardial infarction in Asian patients with acute coronary syndrome as compared with clopidogrel.

Original language	English
Pages (from-to)	122-129
Number of pages	8
Journal	Perfusion (United Kingdom)
Volume	36
Issue number	2
DOIs	https://doi.org/10.1177/0267659120927857
Publication status	Published - 2021 Mar

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Research Foundation of Major Science and Technology Projects of Tianjin Municipal Science and Technology Bureau (grant number: 16ZXMJSY00120), the Natural Science Foundation for Youths of Tianjin (grant number: 16JCQNJC11500), and Tianjin Natural Science Foundation (grant number: 17JCQNJC11400).

Publisher Copyright:
© The Author(s) 2020.

Keywords

acute coronary syndrome
clopidogrel
percutaneous coronary intervention
periprocedural myocardial infarction
ticagrelor

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Safety Research
Cardiology and Cardiovascular Medicine
Advanced and Specialised Nursing

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10.1177/0267659120927857

Cite this

Zhang, Y. R., Xue, Z. K., Chen, K. Y., Xu, L. X., Wang, W. D., Tao, H. Y., Liu, T., Che, J. J., Wang, X. W., Rha, S. W., Wang, J. R., & Wang, P. (2021). Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome. Perfusion (United Kingdom), 36(2), 122-129. https://doi.org/10.1177/0267659120927857

@article{4cae5ab0511c4da18bc94248986af940,

title = "Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome",

abstract = "Background: Periprocedural myocardial infarction is a common complication following percutaneous coronary intervention. The present study was conducted with an aim to compare the safety and efficacy of loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. Methods: A total of 114 patients with acute coronary syndrome undergoing elective percutaneous coronary intervention were assigned to clopidogrel group (n = 57, the loading and maintenance doses were 300 and 75 mg qd for clopidogrel, and 300 and 100 mg qd for aspirin), or ticagrelor group (n = 57, the loading and maintenance doses were 180 and 90 mg bid for ticagrelor, and 300 and 100 mg qd for aspirin). Cardiac biomarkers were measured before, 8 hours, and 24 hours after percutaneous coronary intervention. The percutaneous coronary intervention–related periprocedural myocardial infarction was defined according to the fourth universal definition of myocardial infarction (2018). Results: The overall incidence of percutaneous coronary intervention–related periprocedural myocardial infarction was 21.1%. The ticagrelor group showed a significantly lower incidence of periprocedural myocardial infarction (12.3% vs 29.8%, p = 0.022) and numerically lower bleeding events (3.5% vs 8.8%, p = 0.242) as compared with clopidogrel group. No patient had major adverse cardiovascular events during the 1-month follow-up. The levels of high-sensitivity C-reactive protein did not differ significantly between the two groups (p > 0.05), indicating that the benefits of ticagrelor were not from its anti-inflammatory effects. Multivariable analysis showed that the use of ticagrelor (odds ratio: 0.50; 95% confidence interval: 0.29-0.87; p = 0.014) and number of stents (odds ratio: 2.75; 95% confidence interval: 1.25-6.06; p = 0.012) were independent predictors of periprocedural myocardial infarction. Conclusion: Pretreatment with a loading dose of ticagrelor seems to be superior in reducing the incidence of percutaneous coronary intervention–related periprocedural myocardial infarction in Asian patients with acute coronary syndrome as compared with clopidogrel.",

keywords = "acute coronary syndrome, clopidogrel, percutaneous coronary intervention, periprocedural myocardial infarction, ticagrelor",

author = "Zhang, {Ya Ru} and Xue, {Zheng Kai} and Chen, {Kang Yin} and Xu, {Ling Xia} and Wang, {Wei Ding} and Tao, {Hua Yue} and Tong Liu and Che, {Jing Jin} and Wang, {Xue Wen} and Rha, {Seung Woon} and Wang, {Jia Rui} and Peng Wang",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Research Foundation of Major Science and Technology Projects of Tianjin Municipal Science and Technology Bureau (grant number: 16ZXMJSY00120), the Natural Science Foundation for Youths of Tianjin (grant number: 16JCQNJC11500), and Tianjin Natural Science Foundation (grant number: 17JCQNJC11400). Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2021",

month = mar,

doi = "10.1177/0267659120927857",

language = "English",

volume = "36",

pages = "122--129",

journal = "Perfusion (United Kingdom)",

issn = "0267-6591",

publisher = "SAGE Publications Ltd",

number = "2",

}

TY - JOUR

T1 - Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome

AU - Zhang, Ya Ru

AU - Xue, Zheng Kai

AU - Chen, Kang Yin

AU - Xu, Ling Xia

AU - Wang, Wei Ding

AU - Tao, Hua Yue

AU - Liu, Tong

AU - Che, Jing Jin

AU - Wang, Xue Wen

AU - Rha, Seung Woon

AU - Wang, Jia Rui

AU - Wang, Peng

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Research Foundation of Major Science and Technology Projects of Tianjin Municipal Science and Technology Bureau (grant number: 16ZXMJSY00120), the Natural Science Foundation for Youths of Tianjin (grant number: 16JCQNJC11500), and Tianjin Natural Science Foundation (grant number: 17JCQNJC11400). Publisher Copyright: © The Author(s) 2020.

PY - 2021/3

Y1 - 2021/3

N2 - Background: Periprocedural myocardial infarction is a common complication following percutaneous coronary intervention. The present study was conducted with an aim to compare the safety and efficacy of loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. Methods: A total of 114 patients with acute coronary syndrome undergoing elective percutaneous coronary intervention were assigned to clopidogrel group (n = 57, the loading and maintenance doses were 300 and 75 mg qd for clopidogrel, and 300 and 100 mg qd for aspirin), or ticagrelor group (n = 57, the loading and maintenance doses were 180 and 90 mg bid for ticagrelor, and 300 and 100 mg qd for aspirin). Cardiac biomarkers were measured before, 8 hours, and 24 hours after percutaneous coronary intervention. The percutaneous coronary intervention–related periprocedural myocardial infarction was defined according to the fourth universal definition of myocardial infarction (2018). Results: The overall incidence of percutaneous coronary intervention–related periprocedural myocardial infarction was 21.1%. The ticagrelor group showed a significantly lower incidence of periprocedural myocardial infarction (12.3% vs 29.8%, p = 0.022) and numerically lower bleeding events (3.5% vs 8.8%, p = 0.242) as compared with clopidogrel group. No patient had major adverse cardiovascular events during the 1-month follow-up. The levels of high-sensitivity C-reactive protein did not differ significantly between the two groups (p > 0.05), indicating that the benefits of ticagrelor were not from its anti-inflammatory effects. Multivariable analysis showed that the use of ticagrelor (odds ratio: 0.50; 95% confidence interval: 0.29-0.87; p = 0.014) and number of stents (odds ratio: 2.75; 95% confidence interval: 1.25-6.06; p = 0.012) were independent predictors of periprocedural myocardial infarction. Conclusion: Pretreatment with a loading dose of ticagrelor seems to be superior in reducing the incidence of percutaneous coronary intervention–related periprocedural myocardial infarction in Asian patients with acute coronary syndrome as compared with clopidogrel.

AB - Background: Periprocedural myocardial infarction is a common complication following percutaneous coronary intervention. The present study was conducted with an aim to compare the safety and efficacy of loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. Methods: A total of 114 patients with acute coronary syndrome undergoing elective percutaneous coronary intervention were assigned to clopidogrel group (n = 57, the loading and maintenance doses were 300 and 75 mg qd for clopidogrel, and 300 and 100 mg qd for aspirin), or ticagrelor group (n = 57, the loading and maintenance doses were 180 and 90 mg bid for ticagrelor, and 300 and 100 mg qd for aspirin). Cardiac biomarkers were measured before, 8 hours, and 24 hours after percutaneous coronary intervention. The percutaneous coronary intervention–related periprocedural myocardial infarction was defined according to the fourth universal definition of myocardial infarction (2018). Results: The overall incidence of percutaneous coronary intervention–related periprocedural myocardial infarction was 21.1%. The ticagrelor group showed a significantly lower incidence of periprocedural myocardial infarction (12.3% vs 29.8%, p = 0.022) and numerically lower bleeding events (3.5% vs 8.8%, p = 0.242) as compared with clopidogrel group. No patient had major adverse cardiovascular events during the 1-month follow-up. The levels of high-sensitivity C-reactive protein did not differ significantly between the two groups (p > 0.05), indicating that the benefits of ticagrelor were not from its anti-inflammatory effects. Multivariable analysis showed that the use of ticagrelor (odds ratio: 0.50; 95% confidence interval: 0.29-0.87; p = 0.014) and number of stents (odds ratio: 2.75; 95% confidence interval: 1.25-6.06; p = 0.012) were independent predictors of periprocedural myocardial infarction. Conclusion: Pretreatment with a loading dose of ticagrelor seems to be superior in reducing the incidence of percutaneous coronary intervention–related periprocedural myocardial infarction in Asian patients with acute coronary syndrome as compared with clopidogrel.

KW - acute coronary syndrome

KW - clopidogrel

KW - percutaneous coronary intervention

KW - periprocedural myocardial infarction

KW - ticagrelor

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U2 - 10.1177/0267659120927857

DO - 10.1177/0267659120927857

M3 - Article

C2 - 32522095

AN - SCOPUS:85086340684

SN - 0267-6591

VL - 36

SP - 122

EP - 129

JO - Perfusion (United Kingdom)

JF - Perfusion (United Kingdom)

IS - 2

ER -

Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome

Abstract

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Keywords

ASJC Scopus subject areas

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