Thrombogenicity and endothelial progenitor cells function during Acute myocardial infarction - comparison of Prasugrel versus Ticagrelor

Background: Thrombin generation (TG), platelet function and circulating endothelial progenitor cells (EPCs) have an important role in the pathophysiology of coronary artery disease (CAD). To date, the effect of novel P2Y 12 inhibitors on these aspects has mostly been studied in the sub-acute phase f...

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Published in:Journal of thrombosis and thrombolysis 2023-04, Vol.55 (3), p.407-414
Main Authors: Wiessman, Maya, Kheifets, Mark, Schamroth Pravda, Nili, Leshem Lev, Dorit, Ziv, Eti, Kornowski, Ran, Spectre, Galia, Perl, Leor
Format: Article
Language:English
Subjects:
Adenosine - therapeutic use
Cardiology
Cardiovascular disease
CD34 antigen
Coronary artery disease
Drug therapy
Endothelial Progenitor Cells
Heart attacks
Heart diseases
Hematology
Humans
Medicine
Medicine & Public Health
Myocardial infarction
Myocardial Infarction - etiology
Percutaneous Coronary Intervention - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Platelets
Prasugrel Hydrochloride - therapeutic use
Progenitor cells
Purinergic P2Y Receptor Antagonists - therapeutic use
ST Elevation Myocardial Infarction - drug therapy
Thrombin
Ticagrelor - therapeutic use
Treatment Outcome
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Summary:Background: Thrombin generation (TG), platelet function and circulating endothelial progenitor cells (EPCs) have an important role in the pathophysiology of coronary artery disease (CAD). To date, the effect of novel P2Y 12 inhibitors on these aspects has mostly been studied in the sub-acute phase following myocardial infarction. Objectives: Comparing the effects of prasugrel and ticagrelor on TG and EPCs in the acute phase of ST-segment elevation myocardial infarction (STEMI). Methods: STEMI patients were randomized to either ticagrelor or prasugrel treatment. TG, platelet reactivity and EPCs were evaluated prior to P2Y 12 inhibitor loading dose (T0), and one day following (T1). Results: Between December 2018 - July 2021, 83 consecutive STEMI patients were randomized to ticagrelor (N = 42) or prasugrel (N = 41) treatment. No differences were observed at T0 for all measurements. P2Y 12 reactivity units (PRU) at T1 did not differ as well (prasugrel 13.2 [5.5–20.8] vs. ticagrelor 15.8 [4.0-26.3], p = 0.40). At T1, prasugrel was a significantly more potent TG inhibitor, with longer lag time to TG initiation (7.7 ± 7.5 vs. 3.9 ± 2.1 min, p 
ISSN:1573-742X
0929-5305
1573-742X
DOI:10.1007/s11239-022-02759-6