Author + information
- Salvatore Brugaletta1,
- Josep Gomez Lara2,
- Juan Caballero-Borrego3,
- Luis Ortega-Paz4,
- Luis Teruel Gila5,
- Miriam Jimenez3,
- Rafael Romaguera6,
- Vicente Alcalde Martinez7,
- Marcos Ñato8,
- Eduardo Molina9,
- Joan Antoni Gomez-Hospital10,
- Concepcion Correa Vilchez3,
- Angel Cequier5 and
- Manel Sabate11
- 1hospital clinic, barcelona, Spain
- 2Hospital Universitari de Bellvitge, Hospitalet De Llobregat, Spain
- 3Complejo Hospitalario Universitario de Granada, Granada, Spain
- 4Hospital Clínic of Barcelona, Barcelona, Spain
- 5Bellvitge University Hospital, Barcelona, Spain
- 6Interventional Cardiologist, Barcelona, Spain
- 7Granada Hospital, Granada, Spain
- 8Bellvitge Universitary Hospital., Barcelona, Spain
- 9Hospital Granada, granada, Spain
- 10Bellvitge, Barcelona, Spain
- 11Hospital Clínic; University of Barcelona, Barcelona, Spain
Coronary vascular function of a chronic coronary total occlusion (CTO) immediately after recanalization is demonstrated to be poor. We aim to explore role of Ticagrelor vs. Clopidogrel in improving vascular function in this context.
The TIGER BVS is a prospective, double-randomized, open-label, two parallel-group controlled clinical trial. A total of 50 patients who receive CTO PCI with anterograde approach have been randomized 1:1 to receive Ticagrelor vs. Clopidogrel at least 3 days before the PCI procedure. Immediately after CTO recanalization with Absorb BVS implantation a specific study of vascular function with evaluation of CBF under multiple stepwise adenosine infusion of 2-minute each (0 μg/Kg, 50 μg/Kg, 80 μg/Kg, 110 μg/Kg and 140 μg/Kg) has been performed.
All the CTO were recanalized successfully with ABSORB BVS implantation (1.96±0.9 BVS per patient). Patients in the Ticagrelor group were younger than those in Clopidogrel group (58.64±9.64 vs. 65.36±10.90, p=0.025). There were no other differences in terms of clinical or procedural variables between groups. At linear mixed model, CBF exhibited significantly higher values in the Ticagrelor as compared to Clopidogrel group during multiple stepwise adenosine infusion, even after adjustment for age (p=0.029; Figure 1).
The TIGER BVS trial showed that Ticagrelor may be efficacious in improving coronary vascular flow in CTO patients as compared to Clopidogrel. The clinical value of a higher coronary flow in this context should be evaluated in long-term follow-up.