Comparison of Ticagrelor and Clopidogrel on Inflammatory Biomarkers in Actue Myocardial Infarction Patients ----- A multicenter randomized, open-label and parallel- treatment prospective clinical study

OBJECTIVE The aim of this study was to assess the different impacts on inflammatory biomarkers of ticagrelor or clopidogrel in patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). METHODS This was a multicenter, randomized, open-label and parallel- treatment prospective study. Patients were randomized to receive a loading dose of ticagrelor 180 mg as the treatment group (N = 143) or clopidogrel 600 mg as the control group (N = 184). After PCI, the treatment group was treated with ticagrelor 90 mg twice daily while the control group was treated with clopidogrel 75 mg once daily. The levels of inflammation were tested by sCD40 ligand (CD40L), high sensitivity C-reactive protein (hsCRP) and P-selectin in different time points. RESULTS There were 327 patients participated in this study and no difference in baseline characteristics between groups. No difference was found between groups in baseline levels of inflammation with all assays, and no difference in assays of hsCRP and P-selection in all the time points between groups, but sCD40L decreased significantly in ticagrelor group than clopidegrel group (-2492 ± 7407.3 VS 992.21 ± 10478, P = 0.0095) in 1week after PCI. CONCLUSIONS In STEMI patients undergoing PCI who are receiving anti-platelet therapy, ticagrelor is associated with more potent inflammation inhibition of sCD40L compared with clopidogrel in 1week after PCI. It may open a new path for anti-platelet therapy and large studies are needed to support this finding.