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Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

Comparison of the influence of ticagrelor and clopidogrel on inflammatory biomarkers and vascular endothelial function for patients with ST-segment elevation myocardial infarction receiving emergency percutaneous coronary intervention: study protocol for a randomized controlled trial

Authors: Zhenhua Li, Yueyan Li, Tao Zhang, Wei Miao, Guohai Su

Published in: Trials | Issue 1/2016

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Abstract

Background

The Platelet Inhibition and Patient Outcomes (PLATO, Eur J Prev Cardiol 22(6):734–42, 2015) trial shows that, in patients who have an acute coronary syndrome, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death, but the reason is still uncertain. Both inflammation and vascular endothelian cell dysfunction play important roles in the pathophysiology of atherosclerotic plaques, but whether ticagrelor has superior anti-inflammatory effect and can improve vascular endothelial cell function to a great extent is unknown.

Methods/design

Patients with STEMI who are scheduled to undergo emergency percutaneous coronary intervention (PCI) will be randomly assigned to receive a loading dose of ticagrelor 180 mg as the treatment group or clopidogrel 600 mg as the control group. After PCI, the treatment group will be treated with ticagrelor 90 mg twice daily while the control group will be treated with clopidogrel 75 mg once daily. The vascular endothelial function will be tested by circulating endothelial cells, and levels of inflammation will be tested by CD40 ligand (CD40L), high sensitivity C-reactive protein (hsCRP) and P-selectin. The estimated enrollment sample size will be 350 patients, including 175 in the treatment group and 175 in the control group.

Discussion

This study will compare the influence of ticagrelor and clopidogrel on inflammatory biomarkers and vascular endothelial function firstly for STEMI patients receiving emergency PCI and will provide evidence to identify whether ticagrelor inhibits inflammation and improves vascular endothelial cell function to a greater extent than clopidogrel or not.

Trial registration

This trial was registered with Clinicaltrials.gov (identifier: NCT02123004) on 20 April 2014.
Literature
1.
go back to reference Patel MR, Becker RC, Wojdyla DM, Emanuelsson H, Hiatt WR, Horrow J, et al. Cardiovascular events in acute coronary syndrome patients with peripheral arterial disease treated with ticagrelor compared with clopidogrel: data from the PLATO Trial. Eur J Prev Cardiol. 2015;22(6):734–42.CrossRefPubMed Patel MR, Becker RC, Wojdyla DM, Emanuelsson H, Hiatt WR, Horrow J, et al. Cardiovascular events in acute coronary syndrome patients with peripheral arterial disease treated with ticagrelor compared with clopidogrel: data from the PLATO Trial. Eur J Prev Cardiol. 2015;22(6):734–42.CrossRefPubMed
2.
go back to reference Ridker PM. Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutr Rev. 2007;65(12 Pt 2):S253–9.CrossRefPubMed Ridker PM. Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutr Rev. 2007;65(12 Pt 2):S253–9.CrossRefPubMed
3.
go back to reference Lucas AR, Korol R, Pepine CJ. Inflammation in atherosclerosis: some thoughts about acute coronary syndromes. Circulation. 2006;113(17):e728–32.CrossRefPubMed Lucas AR, Korol R, Pepine CJ. Inflammation in atherosclerosis: some thoughts about acute coronary syndromes. Circulation. 2006;113(17):e728–32.CrossRefPubMed
4.
go back to reference Khuseyinova N, Koenig W. Biomarkers of outcome from cardiovascular disease. Curr Opin Crit Care. 2006;12(5):412–9.CrossRefPubMed Khuseyinova N, Koenig W. Biomarkers of outcome from cardiovascular disease. Curr Opin Crit Care. 2006;12(5):412–9.CrossRefPubMed
5.
go back to reference Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Pro-inflammatory cytokines in acute coronary syndromes: from bench to bedside. Cytokine Growth Factor Rev. 2006;17(4):225–33.CrossRefPubMed Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Pro-inflammatory cytokines in acute coronary syndromes: from bench to bedside. Cytokine Growth Factor Rev. 2006;17(4):225–33.CrossRefPubMed
6.
go back to reference Jawien J. New insights into immunological aspects of atherosclerosis. Pol Arch Med Wewn. 2008;118(3):127–31.PubMed Jawien J. New insights into immunological aspects of atherosclerosis. Pol Arch Med Wewn. 2008;118(3):127–31.PubMed
7.
go back to reference Steinberg D. Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime. Nat Med. 2002;8(11):1211–7.CrossRefPubMed Steinberg D. Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime. Nat Med. 2002;8(11):1211–7.CrossRefPubMed
8.
go back to reference Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol. 2003;23(12):2131–7.CrossRefPubMed Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol. 2003;23(12):2131–7.CrossRefPubMed
11.
12.
go back to reference Yeh ET, Khan BV. The potential role of antiplatelet agents in modulating inflammatory markers in atherothrombosis. J Thromb Haemost. 2006;4(11):2308–16.CrossRefPubMed Yeh ET, Khan BV. The potential role of antiplatelet agents in modulating inflammatory markers in atherothrombosis. J Thromb Haemost. 2006;4(11):2308–16.CrossRefPubMed
13.
go back to reference Muhlestein JB. Effect of antiplatelet therapy on inflammatory markers in atherothrombotic patients. Thromb Haemost. 2010;103(1):71–82.CrossRefPubMed Muhlestein JB. Effect of antiplatelet therapy on inflammatory markers in atherothrombotic patients. Thromb Haemost. 2010;103(1):71–82.CrossRefPubMed
14.
go back to reference Frelinger 3rd AL, Jakubowski JA, Li Y, Barnard MR, Fox ML, Linden MD, et al. The active metabolite of prasugrel inhibits ADP-stimulated thrombo-inflammatory markers of platelet activation: influence of other blood cells, calcium, and aspirin. Thromb Haemost. 2007;98(1):192–200.PubMed Frelinger 3rd AL, Jakubowski JA, Li Y, Barnard MR, Fox ML, Linden MD, et al. The active metabolite of prasugrel inhibits ADP-stimulated thrombo-inflammatory markers of platelet activation: influence of other blood cells, calcium, and aspirin. Thromb Haemost. 2007;98(1):192–200.PubMed
15.
go back to reference Kodama M, Yamasaki Y, Sakamoto K, Yoshioka R, Matsuhisa M, Kajimoto Y, et al. Antiplatelet drugs attenuate progression of carotid intima-media thickness in subjects with type 2 diabetes. Thromb Res. 2000;97(4):239–45.CrossRefPubMed Kodama M, Yamasaki Y, Sakamoto K, Yoshioka R, Matsuhisa M, Kajimoto Y, et al. Antiplatelet drugs attenuate progression of carotid intima-media thickness in subjects with type 2 diabetes. Thromb Res. 2000;97(4):239–45.CrossRefPubMed
16.
go back to reference Redondo S, Santos-Gallego CG, Ganado P, Garcia M, Rico L, Del Rio M, et al. Acetylsalicylic acid inhibits cell proliferation by involving transforming growth factor-beta. Circulation. 2003;107(4):626–9.CrossRefPubMed Redondo S, Santos-Gallego CG, Ganado P, Garcia M, Rico L, Del Rio M, et al. Acetylsalicylic acid inhibits cell proliferation by involving transforming growth factor-beta. Circulation. 2003;107(4):626–9.CrossRefPubMed
17.
go back to reference Martin T, Cardarelli PM, Parry GC, Felts KA, Cobb RR. Cytokine induction of monocyte chemoattractant protein-1 gene expression in human endothelial cells depends on the cooperative action of NF-kappa B and AP-1. Eur J Immunol. 1997;27(5):1091–7.CrossRefPubMed Martin T, Cardarelli PM, Parry GC, Felts KA, Cobb RR. Cytokine induction of monocyte chemoattractant protein-1 gene expression in human endothelial cells depends on the cooperative action of NF-kappa B and AP-1. Eur J Immunol. 1997;27(5):1091–7.CrossRefPubMed
18.
go back to reference Roebuck KA. Regulation of interleukin-8 gene expression. J Interferon Cytokine Res. 1999;19(5):429–38.CrossRefPubMed Roebuck KA. Regulation of interleukin-8 gene expression. J Interferon Cytokine Res. 1999;19(5):429–38.CrossRefPubMed
19.
go back to reference Serebruany VL, Midei MG, Meilman H, Malinin AI, Lowry DR. Platelet inhibition with prasugrel (CS-747) compared with clopidogrel in patients undergoing coronary stenting: the subset from the JUMBO study. Postgrad Med J. 2006;82(968):404–10.PubMedCentralCrossRefPubMed Serebruany VL, Midei MG, Meilman H, Malinin AI, Lowry DR. Platelet inhibition with prasugrel (CS-747) compared with clopidogrel in patients undergoing coronary stenting: the subset from the JUMBO study. Postgrad Med J. 2006;82(968):404–10.PubMedCentralCrossRefPubMed
20.
go back to reference Braun OO, Johnell M, Varenhorst C, James S, Brandt JT, Jakubowski JA, et al. Greater reduction of platelet activation markers and platelet-monocyte aggregates by prasugrel compared to clopidogrel in stable coronary artery disease. Thromb Haemost. 2008;100(4):626–33.PubMed Braun OO, Johnell M, Varenhorst C, James S, Brandt JT, Jakubowski JA, et al. Greater reduction of platelet activation markers and platelet-monocyte aggregates by prasugrel compared to clopidogrel in stable coronary artery disease. Thromb Haemost. 2008;100(4):626–33.PubMed
21.
go back to reference Jennings LK. Mechanisms of platelet activation: need for new strategies to protect against platelet-mediated atherothrombosis. Thromb Haemost. 2009;102(2):248–57.PubMed Jennings LK. Mechanisms of platelet activation: need for new strategies to protect against platelet-mediated atherothrombosis. Thromb Haemost. 2009;102(2):248–57.PubMed
22.
go back to reference Feldman M, Jialal I, Devaraj S, Cryer B. Effects of low-dose aspirin on serum C-reactive protein and thromboxane B2 concentrations: a placebo-controlled study using a highly sensitive C-reactive protein assay. J Am Coll Cardiol. 2001;37(8):2036–41.CrossRefPubMed Feldman M, Jialal I, Devaraj S, Cryer B. Effects of low-dose aspirin on serum C-reactive protein and thromboxane B2 concentrations: a placebo-controlled study using a highly sensitive C-reactive protein assay. J Am Coll Cardiol. 2001;37(8):2036–41.CrossRefPubMed
23.
go back to reference Azar RR, Kassab R, Zoghbi A, Aboujaoude S, El-Osta H, Ghorra P, et al. Effects of clopidogrel on soluble CD40 ligand and on high-sensitivity C-reactive protein in patients with stable coronary artery disease. Am Heart J. 2006;151(2):521. e1–e4.CrossRefPubMed Azar RR, Kassab R, Zoghbi A, Aboujaoude S, El-Osta H, Ghorra P, et al. Effects of clopidogrel on soluble CD40 ligand and on high-sensitivity C-reactive protein in patients with stable coronary artery disease. Am Heart J. 2006;151(2):521. e1–e4.CrossRefPubMed
24.
go back to reference Saw J, Madsen EH, Chan S, Maurer-Spurej E. The ELAPSE (Evaluation of Long-Term Clopidogrel Antiplatelet and Systemic Anti-Inflammatory Effects) study. J Am Coll Cardiol. 2008;52(23):1826–33.CrossRefPubMed Saw J, Madsen EH, Chan S, Maurer-Spurej E. The ELAPSE (Evaluation of Long-Term Clopidogrel Antiplatelet and Systemic Anti-Inflammatory Effects) study. J Am Coll Cardiol. 2008;52(23):1826–33.CrossRefPubMed
25.
go back to reference Steinhubl SR, Badimon JJ, Bhatt DL, Herbert JM, Luscher TF. Clinical evidence for anti-inflammatory effects of antiplatelet therapy in patients with atherothrombotic disease. Vasc Med. 2007;12(2):113–22.CrossRefPubMed Steinhubl SR, Badimon JJ, Bhatt DL, Herbert JM, Luscher TF. Clinical evidence for anti-inflammatory effects of antiplatelet therapy in patients with atherothrombotic disease. Vasc Med. 2007;12(2):113–22.CrossRefPubMed
26.
go back to reference Chen YG, Xu F, Zhang Y, Ji QS, Sun Y, Lu RJ, et al. Effect of aspirin plus clopidogrel on inflammatory markers in patients with non-ST-segment elevation acute coronary syndrome. Chin Med J (Engl). 2006;119(1):32–6. Chen YG, Xu F, Zhang Y, Ji QS, Sun Y, Lu RJ, et al. Effect of aspirin plus clopidogrel on inflammatory markers in patients with non-ST-segment elevation acute coronary syndrome. Chin Med J (Engl). 2006;119(1):32–6.
27.
go back to reference Sluimer JC, Kolodgie FD, Bijnens AP, Maxfield K, Pacheco E, Kutys B, et al. Thin-walled microvessels in human coronary atherosclerotic plaques show incomplete endothelial junctions: relevance of compromised structural integrity for intraplaque microvascular leakage. J Am Coll Cardiol. 2009;53(17):1517–27.PubMedCentralCrossRefPubMed Sluimer JC, Kolodgie FD, Bijnens AP, Maxfield K, Pacheco E, Kutys B, et al. Thin-walled microvessels in human coronary atherosclerotic plaques show incomplete endothelial junctions: relevance of compromised structural integrity for intraplaque microvascular leakage. J Am Coll Cardiol. 2009;53(17):1517–27.PubMedCentralCrossRefPubMed
29.
go back to reference Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993;362(6423):801–9.CrossRefPubMed Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993;362(6423):801–9.CrossRefPubMed
30.
go back to reference Woywodt A, Streiber F, de Groot K, Regelsberger H, Haller H, Haubitz M. Circulating endothelial cells as markers for ANCA-associated small-vessel vasculitis. Lancet. 2003;361(9353):206–10.CrossRefPubMed Woywodt A, Streiber F, de Groot K, Regelsberger H, Haller H, Haubitz M. Circulating endothelial cells as markers for ANCA-associated small-vessel vasculitis. Lancet. 2003;361(9353):206–10.CrossRefPubMed
31.
go back to reference Bull TM, Golpon H, Hebbel RP, Solovey A, Cool CD, Tuder RM, et al. Circulating endothelial cells in pulmonary hypertension. Thromb Haemost. 2003;90(4):698–703.PubMed Bull TM, Golpon H, Hebbel RP, Solovey A, Cool CD, Tuder RM, et al. Circulating endothelial cells in pulmonary hypertension. Thromb Haemost. 2003;90(4):698–703.PubMed
32.
go back to reference Mutin M, Canavy I, Blann A, Bory M, Sampol J, Dignat-George F. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells. Blood. 1999;93(9):2951–8.PubMed Mutin M, Canavy I, Blann A, Bory M, Sampol J, Dignat-George F. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells. Blood. 1999;93(9):2951–8.PubMed
33.
go back to reference Vasa M, Fichtlscherer S, Aicher A, Adler K, Urbich C, Martin H, et al. Number and migratory activity of circulating endothelial progenitor cells inversely correlate with risk factors for coronary artery disease. Circ Res. 2001;89(1):E1–7.CrossRefPubMed Vasa M, Fichtlscherer S, Aicher A, Adler K, Urbich C, Martin H, et al. Number and migratory activity of circulating endothelial progenitor cells inversely correlate with risk factors for coronary artery disease. Circ Res. 2001;89(1):E1–7.CrossRefPubMed
34.
go back to reference Damani S, Bacconi A, Libiger O, Chourasia AH, Serry R, Gollapudi R, et al. Characterization of circulating endothelial cells in acute myocardial infarction. Sci Transl Med. 2012;4(126):126ra33.PubMedCentralCrossRefPubMed Damani S, Bacconi A, Libiger O, Chourasia AH, Serry R, Gollapudi R, et al. Characterization of circulating endothelial cells in acute myocardial infarction. Sci Transl Med. 2012;4(126):126ra33.PubMedCentralCrossRefPubMed
35.
go back to reference Ziemianin B, Olszanecki R, Uracz W, Marcinkiewicz E, Gryglewski RJ. Thienopyridines: effects on cultured endothelial cells. J Physiol Pharmacol. 1999;50(4):597–604.PubMed Ziemianin B, Olszanecki R, Uracz W, Marcinkiewicz E, Gryglewski RJ. Thienopyridines: effects on cultured endothelial cells. J Physiol Pharmacol. 1999;50(4):597–604.PubMed
36.
go back to reference Vishnevetsky D, Kiyanista VA, Gandhi PJ. CD40 ligand: a novel target in the fight against cardiovascular disease. Ann Pharmacother. 2004;38(9):1500–8.CrossRefPubMed Vishnevetsky D, Kiyanista VA, Gandhi PJ. CD40 ligand: a novel target in the fight against cardiovascular disease. Ann Pharmacother. 2004;38(9):1500–8.CrossRefPubMed
37.
go back to reference Hancock WW, Buelow R, Sayegh MH, Turka LA. Antibody-induced transplant arteriosclerosis is prevented by graft expression of anti-oxidant and anti-apoptotic genes. Nat Med. 1998;4(12):1392–6.CrossRefPubMed Hancock WW, Buelow R, Sayegh MH, Turka LA. Antibody-induced transplant arteriosclerosis is prevented by graft expression of anti-oxidant and anti-apoptotic genes. Nat Med. 1998;4(12):1392–6.CrossRefPubMed
38.
go back to reference McClung JA, Kruger AL, Ferraris A, Vanella L, Tsenovoy P, Weiss MB, et al. Usefulness of clopidogrel to protect against diabetes-induced vascular damage. Am J Cardiol. 2010;105(7):1014–8.CrossRefPubMed McClung JA, Kruger AL, Ferraris A, Vanella L, Tsenovoy P, Weiss MB, et al. Usefulness of clopidogrel to protect against diabetes-induced vascular damage. Am J Cardiol. 2010;105(7):1014–8.CrossRefPubMed
39.
go back to reference Nanhwan MK, Ling S, Kodakandla M, Nylander S, Ye Y, Birnbaum Y. Chronic treatment with ticagrelor limits myocardial infarct size: an adenosine and cyclooxygenase-2-dependent effect. Arterioscler Thromb Vasc Biol. 2014;34(9):2078–85.CrossRefPubMed Nanhwan MK, Ling S, Kodakandla M, Nylander S, Ye Y, Birnbaum Y. Chronic treatment with ticagrelor limits myocardial infarct size: an adenosine and cyclooxygenase-2-dependent effect. Arterioscler Thromb Vasc Biol. 2014;34(9):2078–85.CrossRefPubMed
40.
go back to reference Cannon CP, Husted S, Harrington RA, Scirica BM, Emanuelsson H, Peters G, et al. Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patients with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial. J Am Coll Cardiol. 2007;50(19):1844–51.CrossRefPubMed Cannon CP, Husted S, Harrington RA, Scirica BM, Emanuelsson H, Peters G, et al. Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patients with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial. J Am Coll Cardiol. 2007;50(19):1844–51.CrossRefPubMed
41.
go back to reference Husted S, Storey RF, Harrington RA, Emanuelsson H, Cannon CP. Changes in inflammatory biomarkers in patients treated with ticagrelor or clopidogrel. Clin Cardiol. 2010;33(4):206–12.CrossRefPubMed Husted S, Storey RF, Harrington RA, Emanuelsson H, Cannon CP. Changes in inflammatory biomarkers in patients treated with ticagrelor or clopidogrel. Clin Cardiol. 2010;33(4):206–12.CrossRefPubMed
42.
go back to reference Fuster V. Understanding the coronary disease process and the potential for prevention: a summary. Prev Med. 1999;29(6 Pt 2):S9–10.PubMed Fuster V. Understanding the coronary disease process and the potential for prevention: a summary. Prev Med. 1999;29(6 Pt 2):S9–10.PubMed
43.
go back to reference Ayala TH, Schulman SP. Pathogenesis and early management of non-ST-segment elevation acute coronary syndromes. Cardiol Clin. 2006;24(1):19–35.CrossRefPubMed Ayala TH, Schulman SP. Pathogenesis and early management of non-ST-segment elevation acute coronary syndromes. Cardiol Clin. 2006;24(1):19–35.CrossRefPubMed
44.
go back to reference Packard KA, Campbell JA, Knezevich JT, Davis EM. Emerging antiplatelet therapy for coronary artery disease and acute coronary syndrome. Pharmacotherapy. 2012;32(3):244–73.CrossRefPubMed Packard KA, Campbell JA, Knezevich JT, Davis EM. Emerging antiplatelet therapy for coronary artery disease and acute coronary syndrome. Pharmacotherapy. 2012;32(3):244–73.CrossRefPubMed
45.
go back to reference Krishna V, Diamond GA, Kaul S. Do platelet function testing and genotyping improve outcome in patients treated with antithrombotic agents?: the role of platelet reactivity and genotype testing in the prevention of atherothrombotic cardiovascular events remains unproven. Circulation. 2012;125(10):1288–303. discussion 303.CrossRefPubMed Krishna V, Diamond GA, Kaul S. Do platelet function testing and genotyping improve outcome in patients treated with antithrombotic agents?: the role of platelet reactivity and genotype testing in the prevention of atherothrombotic cardiovascular events remains unproven. Circulation. 2012;125(10):1288–303. discussion 303.CrossRefPubMed
46.
go back to reference Serebruany V, Cherala G, Williams C, Surigin S, Booze C, Kuliczkowski W, et al. Association of platelet responsiveness with clopidogrel metabolism: role of compliance in the assessment of “resistance”. Am Heart J. 2009;158(6):925–32.CrossRefPubMed Serebruany V, Cherala G, Williams C, Surigin S, Booze C, Kuliczkowski W, et al. Association of platelet responsiveness with clopidogrel metabolism: role of compliance in the assessment of “resistance”. Am Heart J. 2009;158(6):925–32.CrossRefPubMed
47.
go back to reference Stone GW, Witzenbichler B, Weisz G, Rinaldi MJ, Neumann FJ, Metzger DC, et al. Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents (ADAPT-DES): a prospective multicentre registry study. Lancet. 2013;382(9892):614–23.CrossRefPubMed Stone GW, Witzenbichler B, Weisz G, Rinaldi MJ, Neumann FJ, Metzger DC, et al. Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents (ADAPT-DES): a prospective multicentre registry study. Lancet. 2013;382(9892):614–23.CrossRefPubMed
48.
go back to reference Tantry US, Bonello L, Aradi D, Price MJ, Jeong YH, Angiolillo DJ, et al. Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding. J Am Coll Cardiol. 2013;62(24):2261–73.CrossRefPubMed Tantry US, Bonello L, Aradi D, Price MJ, Jeong YH, Angiolillo DJ, et al. Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding. J Am Coll Cardiol. 2013;62(24):2261–73.CrossRefPubMed
49.
go back to reference Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045–57.CrossRefPubMed Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045–57.CrossRefPubMed
50.
go back to reference Steg PG, Harrington RA, Emanuelsson H, Katus HA, Mahaffey KW, Meier B, et al. Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: an analysis from the prospective, randomized PLATO trial. Circulation. 2013;128(10):1055–65.CrossRefPubMed Steg PG, Harrington RA, Emanuelsson H, Katus HA, Mahaffey KW, Meier B, et al. Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: an analysis from the prospective, randomized PLATO trial. Circulation. 2013;128(10):1055–65.CrossRefPubMed
51.
go back to reference Braunwald E. Unstable angina: an etiologic approach to management. Circulation. 1998;98(21):2219–22.CrossRefPubMed Braunwald E. Unstable angina: an etiologic approach to management. Circulation. 1998;98(21):2219–22.CrossRefPubMed
52.
go back to reference Armstrong EJ, Morrow DA, Sabatine MS. Inflammatory biomarkers in acute coronary syndromes. Part I: introduction and cytokines. Circulation. 2006;113(6):e72–5.CrossRefPubMed Armstrong EJ, Morrow DA, Sabatine MS. Inflammatory biomarkers in acute coronary syndromes. Part I: introduction and cytokines. Circulation. 2006;113(6):e72–5.CrossRefPubMed
53.
go back to reference Vilahur G, Badimon L. Ischemia/reperfusion activates myocardial innate immune response: the key role of the toll-like receptor. Front Physiol. 2014;5:496.PubMedCentralCrossRefPubMed Vilahur G, Badimon L. Ischemia/reperfusion activates myocardial innate immune response: the key role of the toll-like receptor. Front Physiol. 2014;5:496.PubMedCentralCrossRefPubMed
Metadata
Title
Comparison of the influence of ticagrelor and clopidogrel on inflammatory biomarkers and vascular endothelial function for patients with ST-segment elevation myocardial infarction receiving emergency percutaneous coronary intervention: study protocol for a randomized controlled trial
Authors
Zhenhua Li
Yueyan Li
Tao Zhang
Wei Miao
Guohai Su
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1168-9

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