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Ticagrelor

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https://www.readbyqxmd.com/read/29025684/ninety-day-readmission-and-long-term-mortality-in-medicare-patients-%C3%A2-65-years-treated-with-ticagrelor-versus-prasugrel-after-percutaneous-coronary-intervention-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#1
Chris Song, Devraj Sukul, Milan Seth, James M Dupree, Akshay Khandelwal, Simon R Dixon, David Wohns, Thomas LaLonde, Hitinder S Gurm
Ticagrelor and prasugrel were found to be superior to clopidogrel for the treatment of acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI); however, the comparative effectiveness of these 2 drugs remains unknown. We compared postdischarge outcomes among older patients treated with ticagrelor versus prasugrel after PCI for ACS. We linked clinical data from PCIs performed in older patients (age ≥65) for ACS at 47 Michigan hospitals to Medicare fee-for-service claims from January 1, 2013, to December 31, 2014, to ascertain rates of 90-day readmission and long-term mortality...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29023473/comparison-of-bioavailability-and-antiplatelet-action-of-ticagrelor-in-patients-with-st-elevation-myocardial-infarction-and-non-st-elevation-myocardial-infarction-a-prospective-observational-single-centre-study
#2
Piotr Adamski, Joanna Sikora, Ewa Laskowska, Katarzyna Buszko, Małgorzata Ostrowska, Julia M Umińska, Adam Sikora, Natalia Skibińska, Przemysław Sobczak, Urszula Adamska, Danuta Rość, Aldona Kubica, Przemysław Paciorek, Michał P Marszałł, Eliano P Navarese, Diana A Gorog, Jacek Kubica
BACKGROUND: Data from available studies suggest that the presence of ST-elevation myocardial infarction (STEMI) may be associated with delayed and attenuated ticagrelor bioavailability and effect compared with non-ST-elevation myocardial infarction (NSTEMI). METHODS: In a single-center, prospective, observational trial 73 patients with myocardial infarction (STEMI n = 49, NSTEMI n = 24) underwent a pharmacokinetic and pharmacodynamic assessment after a 180 mg ticagrelor loading dose (LD)...
2017: PloS One
https://www.readbyqxmd.com/read/29022423/combination-antiplatelet-treatment-in-coronary-artery-disease-patients-a-necessary-evil-or-an-overzealous-practice
#3
Dimitrios Alexopoulos, Konstantinos Katogiannis, Danai Sfantou, John Lekakis
In seeking to improve care in coronary artery disease patients, further platelet inhibition has been occasionally applied beyond that provided by aspirin and a P2Y12 receptor antagonist. This review aims to offer insights about the rationale, the efficacy and safety of combination antiplatelet therapy, involving three or more agents. Overall, the use of glycoprotein (GP) IIb/IIIa inhibitors did not significantly modify the treatment effect of different antiplatelet strategies, including double vs standard clopidogrel, prasugrel vs clopidogrel, ticagrelor vs clopidogrel, cangrelor vs clopidogrel, and vorapaxar vs placebo...
October 12, 2017: Platelets
https://www.readbyqxmd.com/read/29020490/impact-of-ticagrelor-on-p2y1-and-p2y12-localization-and-on-cholesterol-levels-in-platelet-plasma-membrane
#4
Vahideh Rabani, Damien Montange, Nicolas Meneveau, Siamak Davani
Ticagrelor is an antiplatelet agent that inhibits platelet activation via P2Y12 antagonism. There are several studies showing that P2Y12 needs lipid rafts to be activated, but there are few data about how ticagrelor impacts lipid raft organization. Therefore, we aimed to investigate how ticagrelor could impact the distribution of cholesterol and consequently alter the organization of lipid rafts on platelet plasma membranes. We identified cholesterol-enriched raft fractions in platelet membranes by quantification of their cholesterol levels...
October 11, 2017: Platelets
https://www.readbyqxmd.com/read/28994036/comparison-of-4-different-strategies-of-dapt-after-pci-in-acs-real-world-population-from-a-northern-italy-registry
#5
Marta Rasia, Emilia Solinas, Massimiliano Marino, Paolo Guastaroba, Alberto Menozzi, Maria Alberta Cattabiani, Iacopo Tadonio, Rossana De Palma, Luigi Vignali
Aim of the study was to compare four different strategies of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) treated with PCI. DAPT with Clopidogrel, Ticagrelor and Prasugrel has proved to be effective in patients with ACS treated with percutaneous coronary intervention (PCI) by reducing major adverse cardiovascular outcomes (MACE). However, the effect of the different strategies in a real-world population deserves further verification. A retrospective analysis of 2404 discharged ACS patients treated with PCI was performed, with a median follow-up of 1 year...
October 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28982722/differences-in-relative-and-absolute-effectiveness-of-oral-p2y-12-inhibition-in-men-and-women-a-meta-analysis-and-modelling-study
#6
Kuan Ken Lee, Nicky Welton, Anoop S Shah, Philip D Adamson, Sofia Dias, Atul Anand, David E Newby, Nicholas L Mills, David A McAllister
OBJECTIVE: To estimate the absolute treatment effects of newer P2Y12 inhibitors (ticagrelor and prasugrel) compared with clopidogrel in men and women with acute coronary syndrome (ACS). METHODS: We searched Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials of oral P2Y12 inhibitors for acute stroke or ACS. Age-specific and sex-specific mortality was obtained for all patients admitted to hospital with myocardial infarction in Scotland from 2006 to 2010 (prior to introduction of prasugrel or ticagrelor)...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28977378/postoperative-bleeding-in-coronary-artery-bypass-patients-on-double-antiplatelet-therapy-predictive-value-of-preoperative-aggregometry
#7
Alessandro Della Corte, Ciro Bancone, Andrea Spadafora, Margherita Borrelli, Nicola Galdieri, Sergio Nappo Quintiliano, Olimpia Bifulco, Marisa De Feo
OBJECTIVES: We tested the possible value of routine aggregometry testing for bleeding prediction following coronary artery bypass grafting in patients who received preoperative double antiplatelet therapy. METHODS: In 226 patients undergoing on-pump isolated coronary artery bypass grafting, aggregometry [adenosine diphosphate (ADP) test and ASPI test] was always prospectively performed by Multiplate ® analyser immediately before surgery. We assessed the differences in postoperative bleeding according to the type of double antiplatelet therapy [acetylsalicylic acid plus clopidogrel (ASA+C), or plus ticagrelor, (ASA+T)], duration of clopidogrel/ticagrelor withdrawal (0-3 days or ≥ 4 days) and results of aggregometry tests...
June 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28968313/effect-of-ticagrelor-versus-prasugrel-on-platelet-reactivity-a-meta-analysis
#8
Hengliang Zhang, Pei Zhang, Pingshuan Dong, Xvming Yang, Yanyu Wang, Huifeng Zhang, Junqiang Yan, Yaheng Zhang, Tiantian Zhang, Yanyun Li
BACKGROUND AND OBJECTIVE: Whether ticagrelor is superior to prasugrel in inhibiting platelet reactivity (PR) has remained unclear, possibly because different test methods have been used to determine this. Therefore, using a different test method, we performed a meta-analysis comparing the effects of ticagrelor and prasugrel on PR. METHODS AND RESULTS: PubMed, Embase, Web of Science, and Google Scholar were searched - without language restrictions (last updated on 26 February 2017) - for randomized trials comparing the effects of prasugrel with those of ticagrelor in patients with coronary artery disease...
November 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28959112/a-rare-case-of-ticagrelor-induced-profound-isolated-thrombocytopenia
#9
Wun-Zhih Siao, Wei-Yuan Chuang, Chun-Hung Su, Shao-Fan Huang, Wen-Kuei Tu, Kuei-Chuan Chan
Ticagrelor is a new oral antiplatelet drug that has a strong proven benefit of reducing the rate of death from cardiovascular causes, myocardial infarction, and stroke compared with clopidogrel. Ticagrelor is widely used by patients with acute coronary syndrome. However, profound thrombocytopenia has never been previously reported in such patients. We herein present our experience with a case of profound thrombocytopenia after ticagrelor administration. No drug possibly associated with thrombocytopenia was concomitantly prescribed...
September 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28955389/comparison-of-the-infarct-size-between-the-loading-of-ticagrelor-and-clopidogrel-in-patients-with-acute-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#10
Kyeong Ho Yun, Sang Jae Rhee, Jum Suk Ko
BACKGROUND AND OBJECTIVES: Ticagrelor is considered a potent antiplatelet agent compared to clopidogrel. However, there are no studies regarding the effect of ticagrelor loading on infarct size in patients with ST-segment elevation myocardial infarction (STEMI) in a primary percutaneous coronary intervention (PCI) setting. SUBJECTS AND METHODS: In this single-center, randomized, open-label study, 188 patients who underwent primary PCI for STEMI were enrolled (92 patients in the clopidogrel group and 96 in the ticagrelor group) and compared the infarct size by technetium-99m (Tc-99m) tetrofosmin single-photon emission computed tomography (SPECT) and serial cardiac biomarker levels between the groups...
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28955386/effects-of-ticagrelor-on-myocardial-infarct-size
#11
EDITORIAL
Joo-Yong Hahn
No abstract text is available yet for this article.
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28948299/-cardiogenic-shock-current-evidence
#12
H Thiele
This CME article addresses the pathophysiology, incidence, current survival outcome and treatment options for patients with cardiogenic shock as a complication of acute myocardial infarction. The shock spiral of left heart failure due to cardiac infarction, subsequent vasoconstriction and paradoxical vasodilation due to the systemic inflammation response syndrome (SIRS) is a vicious circle which must be interrupted. Treatment focuses on the evidence from randomized clinical trials and the current guideline recommendations...
September 25, 2017: Herz
https://www.readbyqxmd.com/read/28945935/efficacy-and-safety-of-ticagrelor-in-patients-with-acute-coronary-syndrome-a-meta-analysis-of-randomized-controlled-trials
#13
Yunyan Jing, Bin Ni, Donglai Zhou, Xingwei Zhang, Shanxin Liu
Acute coronary syndrome (ACS) is a dangerous and urgent clinical pattern of coronary artery disease. Aspirin and adenosine diphosphate P2Y12 receptor antagonists are the standard dual anti-platelet therapy for patients with ACS. Ticagrelor is a new oral antagonist of the adenosine diphosphate P2Y12 receptor. Randomized controlled trials (RCTs) have evaluated the efficacy and safety of ticagrelor compared to clopidogrel or prasugrel in patients with ACS, obtaining conflicting results. Thus, we conducted a meta-analysis of these RCTs to determine the efficacy and safety of ticagrelor in patients with ACS...
September 25, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28939715/precatheterization-use-of-p2y12-inhibitors-in-non-st-elevation-myocardial-infarction-patients-undergoing-early-cardiac-catheterization-and-in-hospital-coronary-artery-bypass-grafting-insights-from-the-national-cardiovascular-data-registry-%C3%A2
#14
Marwan Badri, Amr Abdelbaky, Shuang Li, Karen Chiswell, Tracy Y Wang
BACKGROUND: Current guidelines recommend early P2Y12 inhibitor administration in non-ST-elevation myocardial infarction, but it is unclear if precatheterization use is associated with longer delays to coronary artery bypass grafting (CABG) or higher risk of post-CABG bleeding and transfusion. This study examines the patterns and outcomes of precatheterization P2Y12 inhibitor use in non-ST-elevation myocardial infarction patients who undergo CABG. METHODS AND RESULTS: Retrospective analysis was done of 20 304 non-ST-elevation myocardial infarction patients in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry (2009-2014) who underwent catheterization within 24 hours of admission and CABG during the index hospitalization...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939567/association-between-gender-and-short-term-outcome-in-patients-with-st-elevation-myocardial-infraction-participating-in-the-international-prospective-randomised-administration-of-ticagrelor-in-the-catheterisation-laboratory-or-in-the-ambulance-for-new-st-elevation
#15
Dimitrios Venetsanos, Sofia Sederholm Lawesson, Joakim Alfredsson, Magnus Janzon, Angel Cequier, Mohamed Chettibi, Shaun G Goodman, Arnoud W Van't Hof, Gilles Montalescot, Eva Swahn
OBJECTIVES: To evaluate gender differences in outcomes in patents with ST-segment elevation myocardial infarction (STEMI) planned for primary percutaneous coronary intervention (PPCI). SETTINGS: A prespecified gender analysis of the multicentre, randomised, double-blind Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery. PARTICIPANTS: Between September 2011 and October 2013, 1862 patients with STEMI and symptom duration <6 hours were included...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28938956/effects-of-ticagrelor-versus-clopidogrel-on-platelet-function-in-fibrinolytic-treated-stemi-patients-undergoing-early-pci
#16
RANDOMIZED CONTROLLED TRIAL
Payam Dehghani, Andrea Lavoie, Shahar Lavi, Jennifer J Crawford, Sebastian Harenberg, Rodney H Zimmermann, Jeff Booker, Sheila Kelly, Warren J Cantor, Shamir R Mehta, Akshay Bagai, Shaun G Goodman, Asim N Cheema
OBJECTIVES: Patients undergoing PCI early after fibrinolytic therapy are at high risk for both thrombotic and bleeding complications. We sought to assess the pharmacodynamic effects of ticagrelor versus clopidogrel in the fibrinolytic-treated STEMI patients undergoing early PCI. METHODS AND RESULTS: Patients undergoing PCI within 24 hours of tenecteplase (TNK), aspirin, and clopidogrel for STEMI were randomized to receive additional clopidogrel 300 mg followed by 75 mg daily or ticagrelor 180 mg followed by 90 mg twice daily...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28935927/effects-of-ticagrelor-in-a-mouse-model-of-ischemic-stroke
#17
Keita Yamauchi, Takahiko Imai, Masamitsu Shimazawa, Toru Iwama, Hideaki Hara
Ticagrelor is a direct acting and reversibly binding P2Y12 antagonist approved for the prevention of thromboembolic events. Its potential benefits in ischemic stroke have not been investigated sufficiently. Mice were subjected to 2 hours of transient middle cerebral artery occlusion (MCAO). Mice were orally treated with ticagrelor (10 or 30 mg/kg), aspirin (60 mg/kg), or vehicle at 3 and 24 hours before MCAO and 0 and 6 hours after reperfusion. The infarct volume and neurological deficits 22 hours after reperfusion were evaluated...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28935077/a-prospective-evaluation-of-a-pre-specified-absorb-bvs-implantation-strategy-in-st-segment-elevation-myocardial-infarction-the-bvs-stemi-strategy-it-study
#18
Alfonso Ielasi, Gianluca Campo, Claudio Rapetto, Attilio Varricchio, Bernardo Cortese, Salvatore Brugaletta, Salvatore Geraci, Paolo Vicinelli, Fortunato Scotto di Uccio, Gioel Gabrio Secco, Arnaldo Poli, Elisa Nicolini, Kohki Ishida, Azeem Latib, Maurizio Tespili
OBJECTIVES: The aim of this study was to assess the feasibility and clinical results following a pre-specified bioresorbable scaffold (Absorb BVS) implantation strategy in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Concerns were raised about the safety of Absorb because a non-negligible rate of thrombosis was reported within 30 days and at midterm follow-up after primary percutaneous coronary intervention. METHODS: This was a prospective, multicenter study of patients with STEMI (<75 years of age with symptom onset <12 h) undergoing primary percutaneous coronary intervention with Absorb following a dedicated implantation protocol...
September 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28921624/pharmacodynamics-and-pharmacokinetics-of-ticagrelor-versus-clopidogrel-in-patients-with-acute-coronary-syndromes-and-chronic-kidney-disease
#19
Heyang Wang, Jing Qi, Yi Li, Yunbiao Tang, Chao Li, Jing Li, Yaling Han
BACKGROUND: Pivotal clinical trials found ticagrelor reduced ischemic complications to a greater extent than clopidogrel and what is more, the benefit gradually increased with the reduction on creatinine clearance. However, the underlying mechanisms remains poorly explored. METHODS: This is a single-center, prospective, randomized clinical trial involving 60 hospitalized P2Y12 inhibitor naïve patients with CKD (eGFR<60ml/min/1.73m(2) ) and NSTE-ACS. Eligible patients were randomly assigned in a 1:1 ratio to receive ticagrelor(180 mg loading dose, then 90 mg twice daily followed) or clopidogrel(600 mg loading dose, then 75 mg qd followed)...
September 15, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28921447/structure-pharmacology-and-roles-in-physiology-of-the-p2y12-receptor
#20
Ivar von Kügelgen
P2Y receptors are G-protein-coupled receptors (GPCRs) for extracellular nucleotides. The platelet ADP-receptor which has been denominated P2Y12 receptor is an important target in pharmacotherapy. The receptor couples to Gαi2 mediating an inhibition of cyclic AMP accumulation and additional downstream events including the activation of phosphatidylinositol-3-kinase and Rap1b proteins. The nucleoside analogue ticagrelor and active metabolites of the thienopyridine compounds ticlopidine, clopidogrel and prasugrel block P2Y12 receptors and, thereby, inhibit ADP-induced platelet aggregation...
September 12, 2017: Advances in Experimental Medicine and Biology
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