TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement
Status:
Completed
Trial end date:
2018-05-30
Target enrollment:
Participant gender:
Summary
Rotational atherectomy (RA) prior to angioplasty is the reference treatment for highly
calcified atherosclerotic coronary lesions. It aims at fragmenting calcium deposits into
microscopic particulates to allow less hazardous coronary revascularization and stenting. The
main drawback associated with the procedure is the subsequent enhancement of platelet
aggregation which promotes the distal embolization of micro-thrombi and atherosclerotic
fragments. In order to limit these complications, a double antiplatelet therapy is required
(generally Clopidogrel + Aspirin) when RA procedures are performed. Clopidogrel inhibits the
protein P2Y12 which is a cornerstone in platelet aggregation. Ticagrelor is a new
antiplatelet agent that provides faster and greater P2Y12 inhibition than Clopidogrel. It is
currently indicated to reduce risk of cardiovascular events in patients hospitalized for
coronary revascularization after an acute coronary syndrome. Ticagrelor has never been
evaluated so far in stable coronary patients treated with rotational atherectomy prior to
angioplasty.