Evaluation of the Anti-inflammatory Effects of Ticagrelor and Prasugrel as Add-On Therapy to Aspirin in Diabetic Patients Post-percutaneous Coronary Intervention

Background Diabetes mellitus increases the incidence and severity of acute coronary syndromes (ACS). Dual antiplatelet therapy, combining aspirin and P2Y12 (purinergic 2Y type 12) receptor antagonists, is the cornerstone of therapy post-percutaneous coronary intervention (PCI) in diabetic patients. Beyond their antithrombotic effects, P2Y12 inhibitors may exert anti-inflammatory effects by modulating leukocyte-platelet interactions. Hence, this study aimed to investigate the anti-inflammatory effects of adding either ticagrelor or prasugrel to aspirin in diabetic patients with ACS undergoing PCI, by estimating high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α) levels. Methods A prospective, observational, comparative study was conducted to estimate the changes in hs-CRP, IL-6, and TNF-α levels in the serum over 12 weeks of adding either ticagrelor (Group 1) or prasugrel (Group 2) to aspirin in diabetic patients with ACS undergoing PCI. Results Forty-six patients, with a mean age of 56 ± 9 years, were included in the study. A significant reduction in the number of patients with hs-CRP levels >3 mg/L at 12 weeks, compared to baseline, was seen in both study groups. Additionally, there was a statistically significant reduction in IL-6 and TNF-α levels, within as well as between the study Group 1 (ticagrelor) and Group 2 (prasugrel), at the end of 12 weeks compared to baseline. No major adverse event was reported in the study. Conclusion Both ticagrelor and prasugrel showed anti-inflammatory effects, with ticagrelor showing statistically significant reductions in inflammatory markers, compared to prasugrel, in our study population.