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Ticagrelor improves systemic immune-inflammation index in acute coronary syndrome patients

Mehmet Koray Adali1, Ipek Buber1, Oguz Kilic2

  • 1Department of Cardiology, Pamukkale University, School of Medicine, Denizli, Turkey.

Acta Cardiologica
|September 8, 2021
PubMed

Insights

Ticagrelor demonstrated a significant reduction in key inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-high-density lipoprotein ratio (MHR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), compared to clopidogrel in acute coronary syndrome patients. These findings suggest ticagrelor may offer superior anti-inflammatory effects post-percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Immunology
  • Pharmacology

Background:

  • Inflammation is a key factor in the development of atherosclerosis.
  • Acute coronary syndrome (ACS) patients often exhibit elevated inflammatory markers.
  • Antiplatelet therapies are crucial in managing ACS post-percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To compare the effects of ticagrelor and clopidogrel on inflammatory parameters in ACS patients.
  • To evaluate changes in complete blood count (CBC) and biochemical inflammatory markers.
  • To assess the potential anti-inflammatory benefits of ticagrelor versus clopidogrel.

Main Methods:

  • A study involving 100 ACS patients undergoing PCI, randomized to receive either ticagrelor or clopidogrel with aspirin.
  • Collection of CBC and biochemical data at baseline, 3 months, and 6 months post-ACS.
  • Calculation and comparison of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-high-density lipoprotein ratio (MHR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII).

Main Results:

  • Patients treated with ticagrelor showed significantly lower NLR, PLR, and SII at 3 and 6 months compared to clopidogrel (p < 0.001).
  • The monocyte-to-high-density lipoprotein ratio (MHR) was also significantly lower in the ticagrelor group (p < 0.05).
  • Conversely, white blood cell (WBC) count was higher in the ticagrelor group (p < 0.001).

Conclusions:

  • Ticagrelor treatment was associated with lower levels of NLR, MHR, PLR, and SII in ACS patients compared to clopidogrel.
  • Ticagrelor may possess superior anti-inflammatory properties in ACS patients undergoing PCI.
  • These findings highlight potential differential impacts of P2Y12 inhibitors on systemic inflammation.
Abstract

Keywords:
Ticagreloracute coronary syndromeclopidogrelsystemic immune-inflammation index

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