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Updated: Feb 22, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Comparison of the Infarct Size between the Loading of Ticagrelor and Clopidogrel in Patients with Acute Myocardial
Kyeong Ho Yun1, Sang Jae Rhee1, Jum Suk Ko1
1Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
Insights
Ticagrelor loading did not reduce myocardial infarct size in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Clopidogrel loading resulted in lower cardiac biomarker levels post-PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Ticagrelor is a potent antiplatelet agent.
- Limited data exists on ticagrelor loading's effect on infarct size in STEMI patients undergoing primary PCI.
Purpose of the Study:
- To compare the effect of ticagrelor versus clopidogrel loading on myocardial infarct size in STEMI patients undergoing primary PCI.
Main Methods:
- Single-center, randomized, open-label study with 188 STEMI patients undergoing primary PCI.
- Patients were assigned to either clopidogrel (92) or ticagrelor (96) loading.
- Infarct size assessed by technetium-99m tetrofosmin SPECT and serial cardiac biomarkers (CK-MB, troponin T) post-PCI.
Main Results:
- No significant difference in infarct size between ticagrelor and clopidogrel groups (28.1%±34.5% vs. 32.8%±29.2%; p=0.169).
- Clopidogrel group showed significantly lower peak and cumulative troponin T levels at 8, 24, and 48 hours post-PCI (p=0.029).
- Creatine kinase-myocardial band levels were also lower in the clopidogrel group.
Conclusions:
- Ticagrelor loading before primary PCI did not reduce myocardial infarct size compared to clopidogrel.
- Clopidogrel loading was associated with lower cardiac biomarker release in the early phase after primary PCI for STEMI.
Background And Objectives:
Ticagrelor is considered a potent antiplatelet agent compared to clopidogrel. However, there are no studies regarding the effect of ticagrelor loading on infarct size in patients with ST-segment elevation myocardial infarction (STEMI) in a primary percutaneous coronary intervention (PCI) setting.
Subjects And Methods:
In this single-center, randomized, open-label study, 188 patients who underwent primary PCI for STEMI were enrolled (92 patients in the clopidogrel group and 96 in the ticagrelor group) and compared the infarct size by technetium-99m (Tc-99m) tetrofosmin single-photon emission computed tomography (SPECT) and serial cardiac biomarker levels between the groups. SPECT was performed at a median of 2 days after PCI.
Results:
Baseline clinical and procedural characteristics were similar between the groups. Infarct size on SPECT, was similar between the 2 groups (28.1%±34.5% vs. 32.8%±29.2%; p=0.169). At all time-points after PCI (8, 24, and 48 hours), the peak levels of creatine kinase-myocardial band (CK-MB) and troponin T were lower in the clopidogrel group. The clopidogrel group showed lower cumulative troponin T levels than the ticagrelor group (12.59±10.66 vs. 17.67±19.51 ng/mL; p=0.029).
Conclusion:
Ticagrelor loading before primary PCI was not associated with reduced myocardial infarct size during the first 48 hours, compared to clopidogrel loading.
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