Data from: CMR study comparing antiplatelet therapies in STEMI patients

Ticagrelor has many protective cardiovascular properties beyond potent
antiplatelet action. This study aimed to compare the effects of ticagrelor
versus clopidogrel on infarcted mass, quantified by cardiac magnetic
resonance (CMR), in patients with ST-segment elevation acute myocardial
infarction (STEMI). Adult patients of both sexes with STEMI under a
pharmaco-invasive strategy were included (n=225). Patients were treated by
thrombolysis within six hours of symptom onset and underwent angiography
with percutaneous coronary interventions, when needed, within the first 24
hours. Prior to the invasive procedures, patients were randomly assigned
to receive either ticagrelor or clopidogrel using a centralized
computerized system. Patients were followed on a weekly basis to optimize
their medical therapy. After 30 days, CMR was performed and a smaller
percentage of left ventricular infarcted mass was found with ticagrelor
(p=0.012), despite similar angiographic findings at baseline (Syntax
score, Gensini score, culprit artery, TIMI flow, and myocardial blush). At
30 days, left ventricular ejection fraction (LVEF) was comparable between
groups. Still, the K-means algorithm displayed more homogeneous responses
for smaller infarcted mass and better LVEF among those patients treated
with ticagrelor. Standard lipid panel and most inflammatory parameters
were similar at baseline and after 30 days. However, lower
high-sensitivity troponin T and high-sensitivity C-reactive protein levels
were found in samples collected from patients treated with ticagrelor on
the first day of STEMI. In patients with STEMI under a pharmaco-invasive
strategy, therapy with ticagrelor was associated with a smaller infarct
size than clopidogrel.