Key result
Ticagrelor is linked to lower platelet microRNA expression compared to clopidogrel.
Why the study?
Response to dual antiplatelet therapy in ACS patients post-PCI varies considerably, and certain platelet microRNAs may predict treatment response and influence platelet function.
Does treatment with different P2Y12 inhibitors alter platelet microRNA expression and platelet function in patients with ACS post-PCI?
Observational (n=97)
Does treatment with different P2Y12 inhibitors alter platelet microRNA expression and platelet function in patients with ACS post-PCI?
Effect estimate: fold changes from -1.43 to -1.27
p-value: p=0.028 to 0.048
Platelet microRNAs show differential expression based on the type of P2Y12 inhibitor used and correlate with platelet function, suggesting their potential utility as biomarkers for antiplatelet therapy response.
miR profiling may associate with DAPT response variability; leaves open any role in guiding P2Y12 inhibitor selection.
Introduction: Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) require dual antiplatelet therapy (DAPT). However, the response to treatment can vary considerably. Certain platelet microRNAs (miRs) are suspected to predict DAPT response and influence platelet function. This study aimed to analyze selected miRs’ expressions and compare them among patients treated with different P2Y12 inhibitors while assessing their association with platelet activity and turnover parameters. Materials and methods: We recruited 79 ACS patients post-PCI treated with clopidogrel, ticagrelor, or prasugrel, along with 18 healthy volunteers. Expression levels of miR-126-3p, miR223-3p, miR-21-5p, miR-197-3p, and miR-24-3p, as well as immature platelet fraction (IPF) and ADP-induced platelet reactivity, were measured and compared between groups. Results: Analyses revealed significantly lower expressions of miR-126-3p, miR-223-3p, miR-21-5p, and miR-197-3p in patients treated with ticagrelor, compared to clopidogrel (fold changes from −1.43 to −1.27, p-values from 0.028 to 0.048). Positive correlations were observed between platelet function and the expressions of miR-223-3p (r = 0.400, p = 0.019) and miR-21-5p (r = 0.423, p = 0.013) in patients treated with potent drugs. Additionally, miR-24-3p (r = 0.411, p = 0.012) and miR-197-3p (r = 0.333, p = 0.044) showed correlations with IPF. Conclusions: The identified platelet miRs hold potential as biomarkers for antiplatelet therapy. (ClinicalTrials.gov number, NCT06177587).
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Gumiężna et al. (2023) conducted an observational in Acute coronary syndrome (ACS) (n=97). Ticagrelor vs. Clopidogrel was evaluated on Expression levels of miR-126-3p, miR-223-3p, miR-21-5p, and miR-197-3p (fold changes from -1.43 to -1.27, p=0.028 to 0.048). Ticagrelor treatment was associated with significantly lower expressions of selected platelet microRNAs compared to clopidogrel (fold changes -1.43 to -1.27, p=0.028 to 0.048).
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