Comparison of Ticagrelor with Clopidogrel on Coronary Microvascular Dysfunction Following Acute Myocardial Infarction Using Angiography-Derived Index of Microcirculatory Resistance

• DOI: 10.1007/s10557-024-07619-4
• Publication Date: 2024-09-02T06:01:45Z
• Authors: Jiacheng Fang; Yuxuan Zhang; Yiyue Zheng; Delong Chen; Abuduwufuer Yidilisi; Rui Ji; Jianping Xiang; Xinyi Zhang; Jun Jiang

This research aimed to assess the impact of ticagrelor and clopidogrel on coronary microvascular dysfunction (CMD) prognosis following acute myocardial infarction (AMI), using angiography-derived index microcirculatory resistance (angio-IMR) as a non-invasive assessment tool. In this retrospective study, angio-IMR was performed evaluate CMD before after dual antiplatelet therapy (DAPT) with either (90 mg twice daily, n = 184) or (75 once 72). The primary endpoint is improvement evaluated by (delta angio-IMR) DAPT. Secondary endpoints included reinfarction readmission for heart failure during 2-year follow-up. Compared clopidogrel, exhibited significantly higher delta [− 3.09 (5.14) versus − 1.99 (1.91), P 0.008], indicating superior treatment. Multivariate Cox regression indicated that treatment related reduced risk [8 (4.3) 9 (12.5), adjusted HR 0.329; 95% CI 0.116–0.934; 0.018] [7 (3.8) 8 (11.1), 0.349; 0.125–0.975; 0.026]. Furthermore, serves an independent predictor (HR 0.322; 0.110–0.943; 0.039). results study indicate potential association between improved CMD, well cardiovascular events, including in AMI patients. Further randomized controlled trials are necessary confirm benefits prognosis. clinical trial registered www.clinicaltrials.gov (NCT05978726).