{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:40Z","timestamp":1787018020700,"version":"build-2736575974"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Long-term antiplatelet agents including the potent P2Y12 antagonist ticagrelor are indicated in patients with a previous history of acute coronary syndrome. We sought to compare the effect of ticagrelor with that of aspirin monotherapy on vascular endothelial function in patients with prior acute coronary syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prospective, single center, parallel group, investigator-blinded randomized controlled trial. We randomized 200 patients on long-term aspirin monotherapy with prior acute coronary syndrome in a 1:1 fashion to receive ticagrelor 60 mg BD (n=100) or aspirin 100 mg OD (n=100). The primary end point was change from baseline in brachial artery flow-mediated dilation at 12 weeks. Secondary end points were changes to platelet activation marker (CD41_62p) and endothelial progenitor cell (CD34\/133) count measured by flow cytometry, plasma level of adenosine, IL-6 (interleukin-6) and EGF (epidermal growth factor), and multi-omics profiling at 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After 12 weeks, brachial flow-mediated dilation was significantly increased in the ticagrelor group compared with the aspirin group (ticagrelor: 3.48\u00b13.48% versus aspirin: \u22121.26\u00b12.85%, treatment effect 4.73 [95% CI, 3.85\u20135.62],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Nevertheless ticagrelor treatment for 12 weeks had no significant effect on platelet activation markers, circulating endothelial progenitor cell count or plasma level of adenosine, IL-6, and EGF (all\n                      <jats:italic>P<\/jats:italic>\n                      &gt;0.05). Multi-omics pathway assessment revealed that changes in the metabolism and biosynthesis of amino acids (cysteine and methionine metabolism; phenylalanine, tyrosine, and tryptophan biosynthesis) and phospholipids (glycerophosphoethanolamines and glycerophosphoserines) were associated with improved brachial artery flow-mediated dilation in the ticagrelor group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In patients with prior acute coronary syndrome, ticagrelor 60 mg BD monotherapy significantly improved brachial flow-mediated dilation compared with aspirin monotherapy and was associated with significant changes in metabolomic and lipidomic signatures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT03881943.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/atvbaha.121.317513","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T05:00:15Z","timestamp":1649307615000},"page":"789-798","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Multi-Omics Signatures Link to Ticagrelor Effects on Vascular Function in Patients With Acute Coronary Syndrome"],"prefix":"10.1161","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct03881943","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4159-7635","authenticated-orcid":true,"given":"Chor-Cheung Frankie","family":"Tam","sequence":"first","affiliation":[{"name":"Division of Cardiology, Queen Mary Hospital, The University of Hong Kong, China (C.-C.F.T., Y.-H.C., Y.-K.W., H.-F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-8468","authenticated-orcid":true,"given":"Yap-Hang","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Queen Mary Hospital, The University of Hong Kong, China (C.-C.F.T., Y.-H.C., Y.-K.W., H.-F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuen-Kwun","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Queen Mary Hospital, The University of Hong Kong, China (C.-C.F.T., Y.-H.C., Y.-K.W., H.-F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6932-6904","authenticated-orcid":true,"given":"Zhen","family":"Li","sequence":"additional","affiliation":[{"name":"mProbe Inc, Mountain View, CA (Z.L., X.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiurui","family":"Zhu","sequence":"additional","affiliation":[{"name":"mProbe Inc, Mountain View, CA (Z.L., X.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Jung","family":"Su","sequence":"additional","affiliation":[{"name":"mProbe Taiwan Inc, Taipei (K.-J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anindita","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Center for Biomedical Industry, Department of Molecular Science and Engineering National Taipei University of Technology, Taiwan (A.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuoyuan","family":"Hwa","sequence":"additional","affiliation":[{"name":"Center for Biomedical Industry, Department of Molecular Science and Engineering National Taipei University of Technology, Taiwan (A.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng B.","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University, CA (X.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-7808","authenticated-orcid":true,"given":"Hung-Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Queen Mary Hospital, The University of Hong Kong, China (C.-C.F.T., Y.-H.C., Y.-K.W., H.-F.T.)."},{"name":"Cardiac and Vascular Center, Hong Kong University Shenzhen Hospital, China (H.-F.T.)."},{"name":"Hong Kong-Guangdong Joint Laboratory on Stem Cell and Regenerative 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