Changes in Inflammatory Biomarkers in Patients Treated With Ticagrelor or Clopidogrel
Key result
Ticagrelor did not significantly differ from clopidogrel in its effects on inflammatory biomarkers (CRP, IL-6, MPO, and sCD40L) at 4 weeks in patients with NSTE-ACS.
Why the study?
Does ticagrelor reduce inflammatory biomarkers more than clopidogrel in patients with NSTE-ACS?
Population
990 patients hospitalized within the previous 48 hours with non-ST-segment elevation acute coronary syndromes.
Comparison
Ticagrelor 90 mg twice daily or 180 mg twice… vs Clopidogrel 300 mg initially and then 75 mg once…
Design
RCT, randomized, double-blind, double-dummy
Follow-up
4 weeks
Authors
Discussion
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Implication
Ticagrelor offers no anti-inflammatory advantage over clopidogrel in NSTE-ACS; challenges assumptions of superior pleiotropic effects and supports selection by other factors.
Study Design
Type
RCT (n=990)
Blinding
double-blind, double-dummy
Randomization
randomized
Multicenter
Yes
Structured PICO
Does ticagrelor reduce inflammatory biomarkers more than clopidogrel in patients with NSTE-ACS?
P
Population
990 patients hospitalized within 48 hours with NSTE-ACS, followed for 4 weeks.
I
Intervention
Ticagrelor 90 mg twice daily or 180 mg twice daily (with or without an initial 270 mg loading dose), added to standard treatment including aspirin (325 mg initially, then 75-100 mg daily).
C
Comparator
Clopidogrel 300 mg initially and then 75 mg once daily, added to standard treatment including aspirin.
O
Outcome
Changes in inflammatory biomarkers (C-reactive protein [CRP], interleukin 6 [IL-6], myeloperoxidase [MPO], and soluble CD40 ligand [sCD40L]) upon hospital discharge and after 4 weeks.surrogate
In patients with NSTE-ACS, ticagrelor does not provide additional anti-inflammatory benefits over clopidogrel as measured by CRP, IL-6, MPO, and sCD40L at 4 weeks.
Cite This Study
Husted et al. (2010) conducted an RCT in nonST-segment elevation ACS (NSTE-ACS) (n=990). Ticagrelor vs. Clopidogrel 300 mg initially then 75 mg once daily was evaluated on Inflammatory biomarkers (CRP, IL-6, MPO, and sCD40L). Ticagrelor did not significantly differ from clopidogrel in its effects on inflammatory biomarkers (CRP, IL-6, MPO, and sCD40L) at 4 weeks in patients with NSTE-ACS.