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Cardiovasc Diabetol. 2017 May 19;16(1):68. doi: 10.1186/s12933-017-0543-5.

PRotective Effect on the coronary microcirculation of patients with DIabetes by Clopidogrel or Ticagrelor (PREDICT): study rationale and design. A randomized multicenter clinical trial using intracoronary multimodal physiology.

Author information

1
Unidad de Cardiología Intervencionista, Hospital Clínico San Carlos, 28040, Madrid, Spain. enrico.cerrato@gmail.com.
2
Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy. enrico.cerrato@gmail.com.
3
Unidad de Cardiología Intervencionista, Hospital Clínico San Carlos, 28040, Madrid, Spain.
4
Unidad de Cardiología Intervencionista, Hospital Galdakao, Bilbao, Spain.

Abstract

BACKGROUND:

In diabetic patients a predisposed coronary microcirculation along with a higher risk of distal particulate embolization during primary percutaneous intervention (PCI) increases the risk of peri-procedural microcirculatory damage. However, new antiplatelet agents, in particular Ticagrelor, may protect the microcirculation through its adenosine-mediated vasodilatory effects.

METHODS:

PREDICT is an original, prospective, randomized, multicenter controlled study designed to investigate the protective effect of Ticagrelor on the microcirculation during PCI in patient with diabetes mellitus type 2 or pre-diabetic status. The primary endpoints of this study aim to test (i) the decrease in microcirculatory resistance with antiplatelet therapy (Ticagrelor > Clopidogrel; mechanistic effect) and (ii) the relative microcirculatory protection of Ticagrelor compared to Clopidogrel during PCI (Ticagrelor < Clopidogrel; protective effect).

CONCLUSIONS:

PREDICT will be the first multicentre clinical trial to test the adenosine-mediated vasodilatory effect of Ticagrelor on the microcirculation during PCI in diabetic patients. The results will provide important insights into the prospective beneficial effect of this drug in preventing microvascular impairment related to PCI ( http://www.clinicaltrials.gov No. NCT02698618).

KEYWORDS:

Diabetes; IMR, CFR, FFR; Microcirculation; Ticagrelor

PMID:
28526024
PMCID:
PMC5438565
DOI:
10.1186/s12933-017-0543-5
[Indexed for MEDLINE]
Free PMC Article

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