Ticagrelor Improves Peripheral Arterial Function in Acute Coronary Syndrome Patients: Relationship With Adenosine Plasma Level.

Ticagrelor, a P2Y12 receptor antagonist, significantly reduces the incidence of major cardiovascular events in acute coronary syndrome (ACS) compared with standard treatment with clopidogrel (1). It has been suggested that this benefit effect may be accounted for by its pleiotropic properties via a purinergic mechanism. Indeed, ticagrelor increases the endogenous adenosine plasma level (APL) via red blood cell uptake inhibition in primary ACS patients compared with clopidogrel (2). However, the link between these “pleiotropic” properties and the improvement in microvascular dysfunction (MiD) remains poorly investigated. This study aimed to determine whether the increase in APL achieved with ticagrelor might improve endothelial dysfunction in primary ACS patients.