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

Bulluck, Heerajnarain; Chan, Marieta; Bryant, Jennifer; Chai, Ping; Chawla, Ashish; Chua, Terrance; Chung, Yiu‐Cho; Gao, Fei; Ho, Hee Hwa; Ho, Andrew Fu Wah; Hoe, Andrew John; Imran, Syed Saqib; Lee, Chi‐Hang; Lim, Swee Han; Liew, Boon Wah; Yun, Patrick Lim Zhan; Hock, Marcus Ong Eng; Paradies, Valeria; Roe, Matthew T.; Teo, Lynette; Wong, Aaron; Wong, Evelyn; Wong, Philip; Watson, Timothy; Chan, Mark Y; Tan, Jack Wei Chieh; Hausenloy, Derek J.

doi:10.1002/clc.23110

Cited by 18 publications

(17 citation statements)

References 50 publications

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“…A significant reduction in infarct size was also reported in monkeys when treated with cangrelor 100 . The current Platelet Inhibition to Target Reperfusion Injury (PITRI) trial aims to assess whether cangrelor administered prior to reperfusion will reduce AMI size as well as microvascular obstruction in STEMI patients treated with primary PCI 101 . In a retrospective analysis by Roubille et al 102 including 88 STEMI patients, clopidogrel treatment resulted in a reduction in final infarct size as assessed by cardiac enzyme release.…”

Section: Current and Future Therapeutic Interventions To Prevent Imentioning

confidence: 99%

Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target

Ziegler

Wang

Peter

2019

Cardiovascular Research

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Section: Current and Future Therapeutic Interventions To Prevent Imentioning

confidence: 99%

Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target

Ziegler

Wang

Peter

2019

Cardiovascular Research

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“…The REDUCE-MVI trial [ 91 ] of 110 STEMI patients found no difference between ticagrelor and prasugrel in reducing MVO or infarct size, as assessed by invasive IMR evaluation and CMR at one month. The ongoing PITRI trial will aim to determine whether intravenous cangrelor administered prior to reperfusion reduces infarct size or MVO as assessed by CMR [ 92 ].…”

Section: Therapeutic Approaches In Mvomentioning

confidence: 99%

Acute Coronary Syndromes (ACS)—Unravelling Biology to Identify New Therapies—The Microcirculation as a Frontier for New Therapies in ACS

Vaidya

Tucker

Patel

et al. 2021

Cells

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In acute coronary syndrome (ACS) patients, restoring epicardial culprit vessel patency and flow with percutaneous coronary intervention or coronary artery bypass grafting has been the mainstay of treatment for decades. However, there is an emerging understanding of the crucial role of coronary microcirculation in predicting infarct burden and subsequent left ventricular remodelling, and the prognostic significance of coronary microvascular obstruction (MVO) in mortality and morbidity. This review will elucidate the multifaceted and interconnected pathophysiological processes which underpin MVO in ACS, and the various diagnostic modalities as well as challenges, with a particular focus on the invasive but specific and reproducible index of microcirculatory resistance (IMR). Unfortunately, a multitude of purported therapeutic strategies to address this unmet need in cardiovascular care, outlined in this review, have so far been disappointing with conflicting results and a lack of hard clinical end-point benefit. There are however a number of exciting and novel future prospects in this field that will be evaluated over the coming years in large adequately powered clinical trials, and this review will briefly appraise these.

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“…[ 72 ] The Platelet Inhibition to Target Reperfusion Injury (PITRI) trial is currently ongoing, and is evaluating whether cangrelor administered prior to reperfusion would reduce reperfusion injury, as assessed by CMR in 210 patients (NCT03102723). [ 73 ]…”

Section: Alternative Targets For Cardioprotectionmentioning

confidence: 99%

Cardioprotection for Acute MI in Light of the CONDI2/ERIC-PPCI Trial: New Targets Needed

Giblett

Bulluck

2020

Interv Cardiol

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Protection against ischaemia–reperfusion injury after revascularisation in acute myocardial infarction remains an enigma. Many targets have been identified, but after the failure of the recent Effect of Remote Ischaemic Conditioning on Clinical Outcomes in ST-elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention (CONDI2/ERIC-PPCI) trial to show translation to clinical benefit, there is still no pharmacological or mechanical strategy that has translated to clinical practice. This article addresses the results of the CONDI2/ERIC-PPCI trial in the context of previous studies of ischaemic conditioning, and then considers the prospects for other potential targets of cardioprotection. Finally, the authors examine the pitfalls and challenges in trial design for future investigation of cardioprotective strategies. In particular, this article highlights the need for careful endpoint and patient selection, as well as the need to pay attention to the biology of cardioprotection during the study.

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

Cited by 18 publications

References 50 publications

Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target

Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target

Acute Coronary Syndromes (ACS)—Unravelling Biology to Identify New Therapies—The Microcirculation as a Frontier for New Therapies in ACS

Cardioprotection for Acute MI in Light of the CONDI2/ERIC-PPCI Trial: New Targets Needed

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