Microvascular injury is present in a large proportion of patients with ST-elevation myocardial infarction (STEMI) despite successful revascularization. Ticagrelor potentially mitigates this process by exerting additional adenosine-mediated effects. This study aims to determine whether ticagrelor is associated with a better microvascular function compared to prasugrel as maintenance therapy after STEMI. A total of 110 patients presenting with STEMI and additional intermediate stenosis in another coronary artery will be studied after successful percutaneous coronary intervention (PCI) of the infarct-related artery. Patients will be randomized to treatment with ticagrelor or prasugrel for 1 year. FFR-guided PCI of the non-infarct-related artery will be performed at 1 month. Microvascular function will be assessed by measurement of the index of microcirculatory resistance (IMR) in the infarct-related artery and non-infarct-related artery, immediately after primary PCI and after 1 month. The REDUCE-MVI study will establish whether ticagrelor as a maintenance therapy may improve microvascular function in patients after revascularized STEMI.

Adenosine, Microvascular injury, Prasugrel, ST-elevation myocardial infarction, Ticagrelor
dx.doi.org/10.1007/s12265-016-9691-3, hdl.handle.net/1765/90235
Journal of Cardiovascular Translational Research
Department of Cardiology

Janssens, G.N, van Leeuwen, M.A.H, van der Hoeven, N.W, de Waard, G.A, Nijveldt, R, Diletti, R, … van Royen, N. (2016). Reducing Microvascular Dysfunction in Revascularized Patients with ST-Elevation Myocardial Infarction by Off-Target Properties of Ticagrelor versus Prasugrel. Rationale and Design of the REDUCE-MVI Study. Journal of Cardiovascular Translational Research, 9(3), 249–256. doi:10.1007/s12265-016-9691-3