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Platelet inhibition to target reperfusion injury trial: Rationale and study design

Bulluck, H; Chan, M; Bryant, J; Chai, P; Chawla, A; Chua, T; Chung, Y-C; ... Hausenloy, DJ; + view all (2019) Platelet inhibition to target reperfusion injury trial: Rationale and study design. Clinical Cardiology , 42 (1) pp. 5-12. 10.1002/clc.23110. Green open access

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Abstract

BACKGROUND: In ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI), current oral P2Y12 platelet inhibitors do not provide maximal platelet inhibition at the time of reperfusion. Furthermore, administration of cangrelor prior to reperfusion has been shown in pre-clinical studies to reduce myocardial infarct (MI) size. Therefore, we hypothesize that cangrelor administered prior to reperfusion in STEMI patients will reduce the incidence of microvascular obstruction (MVO) and limit MI size in STEMI patients treated with PPCI. METHODS: The Platelet Inhibition to Target Reperfusion Injury (PITRI) trial, is a phase 2A, multi-center, double-blinded, randomized controlled trial, in which 210 STEMI patients will be randomized to receive either an intravenous (IV) bolus of cangrelor (30μg/kg) followed by a 120 minutes infusion (4 μg/kg/min) or matching saline placebo, initiated prior to reperfusion (NCT03102723). RESULTS: The study started in October 2017 and the anticipated end date would be July 2020. The primary end-point will be MI size quantified by cardiovascular magnetic resonance (CMR) on day 3 post-PPCI. Secondary endpoints will include markers of reperfusion, incidence of MVO, MI size and adverse left ventricular remodelling at 6 months, and major adverse cardiac and cerebrovascular events. SUMMARY: The aim of the PITRI trial is to assess whether cangrelor administered prior to reperfusion would reduce acute MI size and MVO, as assessed by CMR. This article is protected by copyright. All rights reserved.

Type: Article
Title: Platelet inhibition to target reperfusion injury trial: Rationale and study design
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/clc.23110
Publisher version: https://doi.org/10.1002/clc.23110
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Cangrelor, ST-segment elevation myocardial infarction, cardiovascular magnetic resonance imaging, microvascular obstruction, myocardial infarct size, primary percutaneous coronary intervention, reperfusion injury
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science
URI: https://discovery.ucl.ac.uk/id/eprint/10062026
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