Background: In diabetic patients a predisposed coronary microcirculation along with a higher risk of distal particulate\nembolization during primary percutaneous intervention (PCI) increases the risk of peri-procedural microcirculatory\ndamage. However, new antiplatelet agents, in particular Ticagrelor, may protect the microcirculation through its\nadenosine-mediated vasodilatory effects.\nMethods: PREDICT is an original, prospective, randomized, multicenter controlled study designed to investigate\nthe protective effect of Ticagrelor on the microcirculation during PCI in patient with diabetes mellitus type 2 or prediabetic\nstatus. The primary endpoints of this study aim to test (i) the decrease in microcirculatory resistance with\nantiplatelet therapy (Ticagrelor > Clopidogrel; mechanistic effect) and (ii) the relative microcirculatory protection of\nTicagrelor compared to Clopidogrel during PCI (Ticagrelor < Clopidogrel; protective effect).\nConclusions: PREDICT will be the first multicentre clinical trial to test the adenosine-mediated vasodilatory effect of\nTicagrelor on the microcirculation during PCI in diabetic patients. The results will provide important insights into the\nprospective beneficial effect of this drug in preventing microvascular impairment related to PCI (http://www.clinicaltrials.\ngov No. NCT02698618).
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