title: Similar Impact of Clopidogrel or Ticagrelor on Carotid Atherosclerotic Plaque Inflammation.
abstract: BACKGROUND
  Platelets play an important role in inflammation. Inhibitors of the P2Y12receptor, which is involved in platelet activation, may have a direct effect on carotid atherosclerotic plaque inflammation.
  
  
  OBJECTIVE
  We compared the effects of clopidogrel and ticagrelor therapy for carotid atherosclerotic plaque inflammation using18F-fluorodeoxyglucose (18FDG) positron emission tomography (PET) imaging.
  
  
  METHODS
  Fifty patients with acute coronary syndrome and ≥118FDG uptake in the carotid artery (target-to-background ratio [TBR] ≥1.6) were randomized to either clopidogrel or ticagrelor groups. Of these, 46 completed PET examinations at baseline and at 6 months. The primary endpoint was the percent change in TBR of the index vessel at the most diseased segment (MDS).
  
  
  RESULTS
  Baseline characteristics were similar between the 2 groups. At 6-month follow-up, low-density lipoprotein cholesterol and C-reactive protein significantly decreased in both groups (P < 0.001). The TBR of the index vessel and aorta significantly decreased in both groups (P < 0.01). The percent change in the MDS TBR of the index vessel was numerically but not significantly lower in the clopidogrel group than in the ticagrelor group (-9.5 ± 14.6% vs -13.5 ± 19.3%; P = 0.427). Likewise, the percent change in the whole-vessel TBR of the index vessel was not different between the 2 groups (P = 0.166). Similar findings were observed for changes in the MDS TBR (P = 0.412) or whole-vessel TBR of the aorta (P = 0.363).
  
  
  CONCLUSIONS
  Carotid atherosclerotic plaque inflammation significantly decreases to a similar degree following 6 months of either clopidogrel or ticagrelor treatment.
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Minyoung
authors.initials: M
authors.lastname: Oh
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Hyo Sang
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Mineok
authors.initials: M
authors.lastname: Chang
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Dae Hyuk
authors.initials: DH
authors.lastname: Moon
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000241:Adenosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000077144:Clopidogrel; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D056910:Republic of Korea; D012720:Severity of Illness Index; D000077486:Ticagrelor; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D058921:Purinergic P2Y Receptor Antagonists; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000077144:Clopidogrel; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine
keywords: Imaging; P2Y12 inhibitors; clopidogrel; plaque inflammation; positron emission tomography; ticagrelor