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dc.contributor.authorUbaid, Salahaddin*
dc.contributor.authorFord, Thomas J*
dc.contributor.authorBerry, Colin*
dc.contributor.authorMurray, Heather M*
dc.contributor.authorWrigley, Benjamin*
dc.contributor.authorKhan, Nazish*
dc.contributor.authorThomas, Mark R*
dc.contributor.authorArmesilla, Angel L*
dc.contributor.authorTownend, Jon N*
dc.contributor.authorKhogali, Saib S*
dc.contributor.authorMunir, Shahzad*
dc.contributor.authorMartins, Joe*
dc.contributor.authorHothi, Sandeep S*
dc.contributor.authorMcAlindon, Elisa J*
dc.contributor.authorCotton, James M*
dc.date.accessioned2019-06-03T11:14:56Z
dc.date.available2019-06-03T11:14:56Z
dc.date.issued2019-05-26
dc.identifier.citationUbaid, S., Ford, T. J., Berry, C., Murray, H. M., Wrigley, B., Khan, N., Thomas, M. R., Armesilla, A. L., Townend, J. N., Khogali, S. S., Munir, S., Martins, J., Hothi, S. S., McAlindon, E. J. and Cotton, J. M. (2019) Cangrelor vs. Ticagrelor in Patients Treated with Primary Percutaneous Coronary Intervention: Impact on Platelet Activity, Myocardial Microvascular Function and Infarct Size: A randomized controlled trial, Thrombosis and Haemostasis, DOI: 10.1055/s-0039-1688789en
dc.identifier.issn0340-6245en
dc.identifier.doi10.1055/s-0039-1688789en
dc.identifier.urihttp://hdl.handle.net/2436/622391
dc.description.abstractBackground Oral P2Y12 inhibitors take more than 2 hours to achieve full effect in healthy subjects and this action is further delayed in patients with acute myocardial infarction. Intravenous P2Y12 inhibition might lead to more timely and potent anti-platelet effect in the context of emergency primary angioplasty, improving myocardial recovery. Objectives This article compares the efficacy of intravenous cangrelor versus ticagrelor in a ST-elevation myocardial infarction (STEMI) population treated with primary percutaneous coronary intervention (PPCI). Materials and Methods In an open-label, prospective, randomized controlled trial, 100 subjects with STEMI were assigned 1:1 to intravenous cangrelor or oral ticagrelor. The co-primary endpoints were platelet P2Y12 inhibition at infarct vessel balloon inflation time, 4 and 24 hours. Secondary endpoints included indices of coronary microcirculatory function: index of microvascular resistance (IMR), initial infarct size (troponin at 24 hours) and final infarct size at 12 weeks (cardiac magnetic resonance). Secondary endpoints included indices of coronary microcirculatory function (index of microvascular resistance [IMR]), initial infarct size (troponin at 24 hours), final infarct size at 12 weeks (cardiac magnetic resonance), corrected thrombolysis in myocardial infarction (TIMI) frame count, TIMI flow grade, myocardial perfusion grade, and ST-segment resolution (ClinicalTrials.gov NCT02733341). Results P2Y12 inhibition at first balloon inflation time was significantly greater in cangrelor-treated patients (cangrelor P2Y12 reaction unit [PRU] 145.2 ± 50.6 vs. ticagrelor 248.3 ± 55.1). There was no difference in mean PRU at 4 and 24 to 36 hours post-dosing. IMR, final infarct size, angiographic and electrocardiographic measures of reperfusion were all similar between groups. Conclusion Cangrelor produces more potent P2Y12 inhibition at the time of first coronary balloon inflation time compared with ticagrelor. Despite this enhanced P2Y12 inhibition, coronary microvascular function and final infarct size did not differ between groups.en
dc.description.sponsorshipThis work was supported by the South Staffordshire Medical Foundation, the Rotha Abraham Bequest and the Royal Wolverhampton Trust (RE/2015005). This study was sponsored by the Royal Wolverhampton NHS Trust. C.B. and T.F. received funding support from the British Heart Foundation (PG/17/2532884; RE/13/5/30177; RE/18/6134217).en
dc.formatapplication/PDFen
dc.languageEnglish
dc.language.isoenen
dc.publisherThieme Publishingen
dc.relation.urlhttps://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0039-1688789.pdfen
dc.subjectpercutaneous coronary interventionen
dc.subjectinfarct sizeen
dc.subjectmicrocirculationen
dc.subjectmyocardial infarctionen
dc.subjectantiplateleten
dc.titleCangrelor vs. Ticagrelor in Patients Treated with Primary Percutaneous Coronary Intervention: Impact on Platelet Activity, Myocardial Microvascular Function and Infarct Size: A randomized controlled trialen
dc.typeJournal articleen
dc.identifier.journalThrombosis and Haemostasisen
dc.date.updated2019-05-23T10:39:16Z
dc.date.accepted2019-03-23
rioxxterms.funderRoyal Wolverhampton NHS Trust and The British Heart Foundationen
rioxxterms.identifier.projectRE/13/5/30177en
rioxxterms.identifier.projectRE/18/6134217en
rioxxterms.identifier.projectRE/2015005en
rioxxterms.identifier.projectPG/17/2532884en
rioxxterms.versionAMen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
rioxxterms.licenseref.startdate2020-05-26en
refterms.dateFCD2019-06-03T11:14:33Z
refterms.versionFCDAM
refterms.dateFOA2019-06-03T11:14:56Z


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