TY - JOUR
T1 - Effect of ticagrelor and prasugrel on remote myocardial inflammation in patients with acute myocardial infarction with ST-elevation
T2 - a CMR T1 and T2 mapping study
AU - Konijnenberg, Lara S F
AU - Zugwitz, Daša
AU - Everaars, Henk
AU - Hoeven, Nina W van der
AU - Demirkiran, Ahmet
AU - Rodwell, Laura
AU - van Leeuwen, Maarten A H
AU - van Rossum, Albert C
AU - El Messaoudi, Saloua
AU - Riksen, Niels P
AU - van Royen, N.
AU - Nijveldt, Robin
AU - Zugwitz, Da?a
N1 - Funding Information: This is a sub study of the REDUCE-MVI trial, which was initiated by the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands with financial support from Astra Zeneca through an unrestricted research grant. In addition, the study was financed by the Ministry of Economic Affairs of the Netherlands by means of a PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature B.V.
PY - 2023/4
Y1 - 2023/4
N2 - PURPOSE: Acute myocardial ischaemia triggers a non-specific inflammatory response of remote myocardium through the increase of plasma concentrations of acute-phase proteins, which causes myocardial oedema. As ticagrelor has been shown to significantly decrease circulating levels of several pro-inflammatory cytokines in patients after acute myocardial infarction with ST-elevation (STEMI), we sought to investigate a potential suppressive effect of ticagrelor over prasugrel on cardiac magnetic resonance (CMR) T1 and T2 values in remote myocardium.METHODS: Ninety STEMI patients were prospectively included and randomised to receive either ticagrelor or prasugrel maintenance treatment after successful primary percutaneous coronary intervention. Patients underwent CMR after 2-7 days. The protocol included long and short axis cine imaging, T1 mapping, T2 mapping and late gadolinium enhancement imaging.RESULTS: After excluding 30 patients due to either missing images or insufficient quality of the T1 or T2 maps, 60 patients were included in our analysis. Of those, 29 patients were randomised to the ticagrelor group and 31 patients to the prasugrel group. In the remote myocardium, T1 values did not differ between groups (931.3 [919.4-950.4] ms for ticagrelor vs. 932.6 [915.5-949.2] ms for prasugrel (p = 0.94)), nor did the T2 values (53.8 ± 4.6 ms for ticagrelor vs. 53.7 ± 4.7 ms for prasugrel (p = 0.86)). Also, in the infarcted myocardium, T1 and T2 values did not differ between groups.CONCLUSION: In revascularised STEMI patients, ticagrelor maintenance therapy did not show superiority over prasugrel in preventing early remote myocardial inflammation as assessed by CMR T1 and T2 mapping.
AB - PURPOSE: Acute myocardial ischaemia triggers a non-specific inflammatory response of remote myocardium through the increase of plasma concentrations of acute-phase proteins, which causes myocardial oedema. As ticagrelor has been shown to significantly decrease circulating levels of several pro-inflammatory cytokines in patients after acute myocardial infarction with ST-elevation (STEMI), we sought to investigate a potential suppressive effect of ticagrelor over prasugrel on cardiac magnetic resonance (CMR) T1 and T2 values in remote myocardium.METHODS: Ninety STEMI patients were prospectively included and randomised to receive either ticagrelor or prasugrel maintenance treatment after successful primary percutaneous coronary intervention. Patients underwent CMR after 2-7 days. The protocol included long and short axis cine imaging, T1 mapping, T2 mapping and late gadolinium enhancement imaging.RESULTS: After excluding 30 patients due to either missing images or insufficient quality of the T1 or T2 maps, 60 patients were included in our analysis. Of those, 29 patients were randomised to the ticagrelor group and 31 patients to the prasugrel group. In the remote myocardium, T1 values did not differ between groups (931.3 [919.4-950.4] ms for ticagrelor vs. 932.6 [915.5-949.2] ms for prasugrel (p = 0.94)), nor did the T2 values (53.8 ± 4.6 ms for ticagrelor vs. 53.7 ± 4.7 ms for prasugrel (p = 0.86)). Also, in the infarcted myocardium, T1 and T2 values did not differ between groups.CONCLUSION: In revascularised STEMI patients, ticagrelor maintenance therapy did not show superiority over prasugrel in preventing early remote myocardial inflammation as assessed by CMR T1 and T2 mapping.
KW - Acute myocardial infarction
KW - Cardiac magnetic resonance imaging
KW - P2Y inhibitors
KW - Remote inflammation
UR - http://www.scopus.com/inward/record.url?scp=85146262871&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85146262871&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36494503
U2 - https://doi.org/10.1007/s10554-022-02765-y
DO - https://doi.org/10.1007/s10554-022-02765-y
M3 - Article
C2 - 36494503
SN - 1569-5794
VL - 39
SP - 767
EP - 779
JO - international journal of cardiovascular imaging
JF - international journal of cardiovascular imaging
IS - 4
ER -