Projects per year
Abstract / Description of output
BACKGROUND: High-risk coronary atherosclerotic plaque is associated with higher plasma troponin concentrations suggesting ongoing myocardial injury that may be a target for dual antiplatelet therapy.
METHODS: In a randomized, double-blind, placebo-controlled trial, patients with multivessel coronary artery disease underwent coronary 18F-fluoride positron emission tomography/coronary computed tomography scanning and measurement of high-sensitivity cardiac troponin I. Patients were randomized (1:1) to receive ticagrelor 90 mg twice daily or matched placebo. The primary endpoint was troponin I concentration at 30 days in patients with increased coronary 18F-fluoride uptake.
RESULTS: In total, 202 patients were randomized to treatment, and 191 met the pre-specified criteria for inclusion in the primary analysis. In patients with increased coronary 18F-fluoride uptake (120 of 191), there was no evidence that ticagrelor had an effect on plasma troponin concentrations at 30 days (ratio of geometric means for ticagrelor vs. placebo: 1.11; 95% confidence interval: 0.90 to 1.36; p = 0.32). Over 1 year, ticagrelor had no effect on troponin concentrations in patients with increased coronary 18F-fluoride uptake (ratio of geometric means: 0.86; 95% confidence interval: 0.63 to 1.17; p = 0.33).
CONCLUSIONS: Dual antiplatelet therapy with ticagrelor did not reduce plasma troponin concentrations in patients with high-risk coronary plaque, suggesting that subclinical plaque thrombosis does not contribute to ongoing myocardial injury in this setting. (Dual Antiplatelet Therapy to Reduce Myocardial Injury [DIAMOND]; NCT02110303)
(J Am Coll Cardiol Img 2020;13:1549–60) © 2020 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0).
Original language | English |
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Pages (from-to) | 1549-1560 |
Journal | Journal of the American College of Cardiology |
Volume | 13 |
Issue number | 7 |
Early online date | 14 Aug 2019 |
DOIs | |
Publication status | Published - Jul 2020 |
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Dive into the research topics of 'Ticagrelor to Reduce Myocardial Injury in Patients With High-Risk Coronary Artery Plaque'. Together they form a unique fingerprint.Projects
- 7 Finished
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High-sensitivity Cardiac Troponin In The Prevention Of Cardiovascular Disease
Shah, A., Mills, N. & Newby, D.
1/08/19 → 31/07/20
Project: Research
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Molecular THoracic imAging and bioiNformatics Approaches TO Sudden death (THANATOS) Study
Newby, D., Bouhaidar, R. & Moss, A.
UK central government bodies/local authorities, health and hospital authorities
1/06/18 → 31/01/19
Project: Research
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Combined positron emission tomography and magnetic resonance imaging of coronary atherothrombosis
1/12/17 → 30/11/18
Project: Research
Equipment
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Edinburgh Imaging Facility
Anne Grant (Manager), Edwin van Beek (Manager) & Scott Semple (Manager)
Deanery of Clinical SciencesFacility/equipment: Facility
Profiles
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Michelle Williams
- Deanery of Clinical Sciences - Personal Chair of Cardiovascular Imaging
- Centre for Cardiovascular Science
- Edinburgh Imaging
Person: Academic: Research Active , Academic: Research Active (Research Assistant)