In a nutshell
This study investigated the effects of ticagrelor (Brilique) and clopidogrel (Plavix) on aortic stiffness (AS).
They found that ticagrelor was more effective at reducing AS.
Some background
Aortic stiffness (AS) is a common feature of coronary artery disease (CAD). AS can also be a predictor of cardiovascular events (CVE) including heart attack and stroke. AS is caused by a number of factors. One factor is inflammation. This can cause the lining of the aortic artery to change and become stiffer. Endothelial cells form the lining of the artery. Platelets are a blood cell involved in clotting. Platelets can release inflammatory proteins and chemicals. Drugs that target platelets can be used to reduce AS.
Ticagrelor is a drug that blocks P2Y12 receptors. This leads to relaxation of artery muscle, reducing AS. Ticagrelor can also reduce platelet formation. This may also improve endothelial cell function. Clopidogrel is a drug that also targets platelets. It is unclear if ticagrelor or clopidogrel is more effective at reducing AS in patients with CAD.
Methods & findings
This study included 117 patients. 58 patients were included in the 24-hour (acute) study. Patients were randomly assigned to loading (high) dose of either ticagrelor or clopidogrel. Patients underwent an angiography (a procedure to visualize the inside of the heart arteries) to assess the artery. Carotid femoral pulse wave velocity (cfPWV) was used to measure AS.
The second study lasted 30 days (midterm). 59 patients were treated with ticagrelor or clopidogrel after a percutaneous coronary intervention (PCI). PCI is a surgical procedure to restore blood flow through the heart arteries. Markers of inflammation and endothelial cell function were assessed.
In the acute study, cfPWV was significantly lower in ticagrelor versus clopidogrel-treated patients. In the midterm study, cfPWV was also significantly lower in ticagrelor-treated patients only. There was no change with clopidogrel. There was no change in inflammation or endothelial cell function in either study.
The bottom line
The authors concluded that ticagrelor was more effective at reducing AS in patients with CAD.
The fine print
The patients in these studies underwent elective procedures. More investigation is needed in other groups of patients with CAD.
What’s next?
If you have any concerns regarding CAD management please consult with your physician.
Published By :
Journal of the American Heart Association
Date :
Jun 18, 2019
