Comparing Ticagrelor Versus Clopidogrel on Microcirculation
Status:
Completed
Trial end date:
2016-12-31
Target enrollment:
Participant gender:
Summary
Recently, data (PLATO) from an AstraZeneca study of platelet inhibition and patient outcomes,
a Phase III pivotal efficacy and safety study with a duration of up to 12 months comparing
ticagrelor 90 mg twice daily dosing to clopidogrel 75 mg once daily dosing in acute coronary
syndrome patients on ASA background, have demonstrated superiority of ticagrelor over
clopidogrel in the prevention of fatal and non-fatal cardiovascular events. Currently, the
mechanism for this mortality reduction remain uncertain. One hypothesis is a adenosine
mediated theory that ticagrelor has been shown to enhance adenosine-induced vasodilation.
Several experimental and clinical studies support the hypothesis that adenosine could reduce
cardiac ischaemia reperfusion damage. Moreover, recent study has demonstrated that ticagrelor
enhances adenosine-induced coronary vasodilatory responses in healthy humans. However, there
are no available data on coronary circulation effects after chronic treatment of ticagrelor
in patients with ACS who have altered resting coronary blood flow dynamics due to advanced
coronary artery disease.