Key result
Ticagrelor cuts day 8 CRP by ~31% and lowers IL-6 vs clopidogrel in STEMI.
Why the study?
The levels of proinflammatory markers IL-6 and CRP in STEMI patients receiving clopidogrel versus ticagrelor during the in-hospital period were not well characterized.
Does ticagrelor maintenance therapy reduce levels of proinflammatory markers (IL-6 and CRP) compared to clopidogrel in STEMI patients after urgent stenting?
RCT (n=80)
simple random sampling
Does ticagrelor maintenance therapy reduce levels of proinflammatory markers (IL-6 and CRP) compared to clopidogrel in STEMI patients after urgent stenting?
Ticagrelor maintenance therapy significantly reduces proinflammatory markers (CRP and IL-6) compared to clopidogrel in the early post-infarction period in STEMI patients.
Answers are grounded in this paper and cite their sources.
IL-6/CRP levels in STEMI on clopidogrel vs ticagrelor are hypothesis-generating; larger prospective studies needed before clinical implications.
Aim. To assess levels of interleukin-6 (IL-6) and cardial infarction patients receiving clopidogrel or ticaC-reactive protein (CRP) in ST-segment elevation myogrelor in the in-hospital period. Methods. 80 patients with STEMI were included in the study. All patients received a loading dose of aspirin (250 mg) and clopidogrel (600 mg) in the ambulance. All patients underwent urgent coronary angiography with the further stenting of the infarct-related artery with bare-metal stents. All patients were assigned to two groups using simple random sampling. Group 1 patients received a daily maintenance dose of clopidogrel 75 mg. Group 2 patients received a maintenance dose of ticagrelor 90 mg twice daily. Plasma levels of IL-6 and CRP were measured on day 1 after the hospital admission before replacing clopidogrel to ticagrelor and on day 7 after switching clopidogrel to ticagrelor (day 8 of the in-hospital period). Results. Levels of CRP and IL-6 in the early period after STEMI in the groups of patients receiving clopidogrel and ticagrelor were similar (p=0.82 vs. p=0.27, respectively). On day 8, CRP levels in the clopidogrel group were significantly higher than CRP levels in the ticagrelor group on day 8 (25.3 (4.6; 46.4) ml / l vs. 17.5 (4.6; 20.9) mg / l, respectively (p = 0.04). The level of IL-6 in the clopidogrel group on day 8 was significantly higher than the level of IL-6 on day 8 in the ticagrelor group (7.03 (2.7; 11.3) pg / mL, vs. 2.8 (1.8; 4.2) pg / mL, respectively (p = 0.01). Conclusion. Levels of proinflammatory markers were significantly lower in the ticagrelor group on day 8 after STEMI compared to the clopidogrel group.
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Тавлуева et al. (2017) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=80). Ticagrelor vs. Clopidogrel 75 mg daily was evaluated on C-reactive protein (CRP) levels on day 8 (p=0.04). Ticagrelor significantly reduced day 8 levels of CRP (17.5 vs 25.3 mg/L, p=0.04) and IL-6 (2.8 vs 7.03 pg/mL, p=0.01) compared to clopidogrel in patients with STEMI.
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