Rationale and design of the Hunting for the off-target propertIes of Ticagrelor on Endothelial function and other Circulating biomarkers in Humans (HI-TECH) trial

S. Ariotti, M. van Leeuwen, S. Brugaletta, S. Leonardi, K. M. Akkerhuis, E. Rexhaj, G. Janssens, L. Ortega-Paz, D. Rizzotti, J. C. van den Berge, D. Heg, G. Francolini, S. Windecker, M. Valgimigli, HI-TECH Investigators

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Among the 3 approved oral P2Y12 inhibitors for the treatment for patients with acute coronary syndrome (ACS), ticagrelor, but not prasugrel or clopidogrel, has been associated with off-target properties, such as improved endothelial-dependent vasomotion and increased adenosine plasma levels. METHODS: The HI-TECH study (NCT02587260) is a multinational, randomized, open-label, crossover study with a Latin squares design, conducted at 5 European sites, in which patients free from recurrent ischemic or bleeding events >/=30 days after a qualifying ACS were allocated to sequentially receive a 30 +/- 5-day treatment with prasugrel, clopidogrel, and ticagrelor in random order. The primary objective was to evaluate whether ticagrelor, at treatment steady state (ie, after 30 +/- 5 days of drug administration), as compared with both clopidogrel and prasugrel, is associated with an improved endothelial function, assessed with peripheral arterial tonometry. Thirty-six patients undergoing evaluable endothelial function assessment for each of the assigned P2Y12 inhibitor were needed to provide 90% power to detect a 10% relative change of the reactive hyperemia index in the ticagrelor group. CONCLUSION: The HI-TECH study is the first randomized, crossover study aiming to ascertain whether ticagrelor, when administered at approved regimen in post-ACS patients, improves endothelial function as compared with both clopidogrel and prasugrel.
Original languageEnglish
Pages (from-to)128-136
Number of pages9
JournalAmerican Heart Journal
Publication statusPublished - Jul 1 2017


  • Adenosine/administration & dosage/analogs & derivatives
  • Administration, Oral
  • Biomarkers/blood
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Endothelium, Vascular/drug effects/physiopathology
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular/physiopathology/prevention & control
  • Humans
  • Male
  • Percutaneous Coronary Intervention/adverse effects
  • Purinergic P2Y Receptor Antagonists/administration & dosage
  • Secondary Prevention/methods
  • Stents/adverse effects
  • Treatment Outcome
  • Vasodilation/drug effects/physiology


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