Letter by Downey and Cohen Regarding Article, “Protective Effects of Ticagrelor on Myocardial Injury After Infarction”
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To the Editor:
Vilahur et al1 recently reported that ticagrelor offers more cardioprotection than clopidogrel, because it blocks the equilibrative nucleoside transporter-1 and the resulting elevated tissue adenosine exerts additional protective effects on top of any from P2Y12 receptor blockade. Their evidence was that the protection from ticagrelor could be partially blocked by the adenosine receptor blocker 8-(p-sulfophenyl)theophylline. Unfortunately, they did not test whether 8-(p-sulfophenyl)theophylline could block clopidogrel’s protection. Furthermore, in our 2013 study, we showed that an adenosine receptor antagonist could block protection from clopidogrel in a rabbit infarct model.2 In addition, we found the anti-infarct effect of clopidogrel to be equal …