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Ticagrelor versus clopidogrel in reducing inflammatory cell infiltration of thrombus aspirated in patients with ST-elevation myocardial infarction

  • Clinical Trial
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Abstract

Background

Ticagrelor provides more rapid, potent, and consistent anti-platelet efficacy than clopidogrel. This randomized trial aimed to evaluate the anti-inflammation effects of ticagrelor versus clopidogrel on thrombus aspirated from the ST-elevation myocardial infarction (STEMI) patients.

Method

A total of 98 patients with STEMI and intended percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (600-mg loading dose) or ticagrelor (180-mg loading dose), of whom 55 with large thrombus burden underwent thrombus aspiration during PCI. Thrombus specimens were successfully aspirated from 49 patients. Finally, 24 patients in the clopidogrel group and 23 in the ticagrelor group completed the study. Inflammatory cells within thrombi were assessed by hematoxylin–eosin and immunohistochemistry stainings.

Results

Compared with the clopidogrel group, the number of total inflammatory cells per mm2 thrombus area in the ticagrelor group was decreased by 28% (P = 0.009). The numbers of neutrophils and myeloperoxidase-positive cells per mm2 thrombus area in the ticagrelor group were respectively decreased by 35% (P = 0.016) and 28% (P = 0.047), as compared with those in the clopidogrel group. Moreover, ticagrelor treatment reduced the ratio of monocytes number higher than 250 per mm2 thrombus area compared with clopidogrel treatment (4% versus 29%, P = 0.048).

Conclusion

In patients with undergoing PCI for STEMI, the loading dose ticagrelor regimen was associated with a reduction in inflammatory cell infiltration within thrombus compared with the loading dose clopidogrel regimen.

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Acknowledgements

We are grateful to Dr. Zhong Hua Wang, Dr. **n Yong Sun, and Dr. Yi Lun Zou in the Department of Cardiology, the First Affiliated Hospital, Harbin Medical University. The authors would like to acknowledge the department of Clinical Pharmacology of the First Affiliated Hospital, Harbin Medical University.

Funding

This study was supported by grants from the Shenzhen Key Medical Discipline Construction Fund (No.szxk003) and Shenzhen People’s Hospital Young College academic backbone to support project. SYJCYJ 202008.

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Author notes

  1. **g Shen, Guangzhong Liu, Guodong Wu and **n Sun contributed equally to this work.

Authors and Affiliations

  1. Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People’s Hospital(The Second Clinical Medical College, **an UniversityThe First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China

    **g Shen, Guangzhong Liu, Shaohong Dong & **n Sun

  2. Department of Cardiology, the First Affiliated Hospital, Cardiovascular Institute, Harbin Medical University, Harbin, 150001, People’s Republic of China

    Guodong Wu, Lijian Sheng, Zhengyu Cao, Shuyuan Guo & Ye Tian

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  1. **g Shen
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Contributions

**g Shen, Guang Zhong Liu, Guo Dong Wu, **n Sun, and Ye Tian designed and conducted the experiment; **g Shen, Guang Zhang Liu, and Guo Dong Wu.analyzed the data and wrote the manuscript. Lijian Sheng, Zhengyu Cao, Shu Yuan Guo, and Shao Hong Dong conducted the experiments. **g Shen, Guang Zhong Liu, and **n Sun revised the manuscript; and all authors approved the final version of the manuscript.

Corresponding authors

Correspondence to **n Sun or Ye Tian.

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Ethical approval

The study was approved in advance by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University and was conducted in accordance with International Conference on Harmonization Guideline for Good Clinical Practice and Declaration of Helsinki.

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All subjects provided written informed consents before their participation.

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The authors declare no competing interests.

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Cite this article

Shen, J., Liu, G., Wu, G. et al. Ticagrelor versus clopidogrel in reducing inflammatory cell infiltration of thrombus aspirated in patients with ST-elevation myocardial infarction. Eur J Clin Pharmacol 78, 1391–1398 (2022). https://doi.org/10.1007/s00228-022-03348-5

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  • DOI: https://doi.org/10.1007/s00228-022-03348-5

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