Myocardial Infarction Clinical Trial
Official title:
Comparison of Ticagrelor Pharmacokinetics and Pharmacodynamics in ST-elevation Myocardial Infarction and Non-ST-elevation Myocardial Infarction Patients
The purpose of the PINPOINT study is to compare pharmacokinetics (PK) and pharmacodynamics (PD) of ticagrelor in ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) patients designated to invasive strategy. Data regarding comparison of PK and antiplatelet action of ticagrelor in STEMI and NSTEMI are sparse. Recommended dosing regimens of ticagrelor are identical for both STEMI and NSTEMI, although it is not known whether PK and PD features of ticagrelor are uniform in these patients.
The European Society of Cardiology and American Heart Association guidelines recommend use
of ticagrelor or prasugrel as a treatment of choice in patients with both STEMI and NSTEMI
(class of recommendation I, level of evidence B). Recommended dosing regimens of ticagrelor
are identical in STEMI and NSTEMI patients, although epidemiology, clinical approach and
early outcomes differ between these two types of myocardial infarction. It is not known
whether PK and PD features of ticagrelor are uniform in STEMI and NSTEMI patients. However,
the existing body of evidence suggest that PK and PD of ticagrelor may be attenuated in
STEMI patients compared to healthy subjects and patients with stable coronary artery
disease, which may expose STEMI patients at increased risk of developing thrombotic
complications secondary to insufficient platelet inhibition. The PINPOINT study could
provide a valuable insight into the knowledge regarding ticagrelor action in STEMI vs.
NSTEMI patients.
Since there is no reference study comparing pharmacokinetics of ticagrelor in STEMI and
NSTEMI patients, we decided to perform an internal pilot study of approximately 30 patients
(15 patients with each type of myocardial infarction) for estimating the final sample size.
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