Reducing Microvascular Dysfunction in Revascularized Patients with ST-Elevation Myocardial Infarction by Off-Target Properties of Ticagrelor versus Prasugrel. Rationale and Design of the REDUCE-MVI Study

Gladys N. Janssens, Maarten A.H. van Leeuwen, Nina W. van der Hoeven, Guus A. de Waard, Robin Nijveldt, Roberto Diletti, Felix Zijlstra, Clemens von Birgelen, Javier Escaned, Marco Valgimigli, Niels van Royen

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Abstract

Microvascular injury is present in a large proportion of patients with ST-elevation myocardial infarction (STEMI) despite successful revascularization. Ticagrelor potentially mitigates this process by exerting additional adenosine-mediated effects. This study aims to determine whether ticagrelor is associated with a better microvascular function compared to prasugrel as maintenance therapy after STEMI. A total of 110 patients presenting with STEMI and additional intermediate stenosis in another coronary artery will be studied after successful percutaneous coronary intervention (PCI) of the infarct-related artery. Patients will be randomized to treatment with ticagrelor or prasugrel for 1 year. FFR-guided PCI of the non-infarct-related artery will be performed at 1 month. Microvascular function will be assessed by measurement of the index of microcirculatory resistance (IMR) in the infarct-related artery and non-infarct-related artery, immediately after primary PCI and after 1 month. The REDUCE-MVI study will establish whether ticagrelor as a maintenance therapy may improve microvascular function in patients after revascularized STEMI.
Original languageEnglish
Pages (from-to)249-256
JournalJournal of cardiovascular translational research
Volume9
Issue number3
DOIs
Publication statusPublished - 2016

Keywords

  • IR-100388
  • METIS-316645
  • Ticagrelor
  • Prasugrel
  • Microvascular injury
  • ST-elevation myocardial infarction
  • Adenosine

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