Ticagrelor in Remote Ischemic Preconditioning Study

• Status: Completed
• Trial end date: 2018-01-17
• Target enrollment: 0
• Participant gender: All

Summary

Remote ischemic preconditioning (RIPC) reduces periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) through various pathways, including an adenosine-triggered pathway. Ticagrelor inhibits adenosine uptake, thus may potentiate the effects of RIPC.

This randomized trial tested the hypothesis that ticagrelor potentiates the effect of RIPC and reduces PMI, as assessed by post-procedural troponin release

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Hellenic Society of Interventional Cardiology
• Treatments: Clopidogrel; Ticagrelor

Criteria

Inclusion Criteria:

• Provision of informed consent prior to any study specific procedures

• Patients (Female and male) ≥ 18 of age

• Patients with NSTE-ACS undergoing coronary angiography, eligible for PCI

Exclusion Criteria:

• Women of childbearing potential

• Severe comorbidity (estimated life expectancy <6 months)

• Baseline cTnI before PCI that is not stable or falling or is > 5 ×99th percentile URL.

• End-stage renal disease(eGFR<15 ml/min/1.73 m2)

• CRUSADE Bleeding Score >50

• Patients with an indication for oral anticoagulation

• On maintenance therapy with ticagrelor or those that have received clopidogrel for less than 3 days

• Use of nicorandil or glibenclamide

• Concomitant theophylline/aminophylline use

• Known contraindications to the use of ticagrelor Hypersensitivity to the active substance or to any of the excipients

• Active pathological bleeding

• History of intracranial haemorrhage

• Moderate to severe hepatic impairment

• Co-administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir).

• Patients meeting criteria for immediate or early (<24h) invasive strategy based on the current relevant European Society of Cardiology guidelines