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Ticagrelor

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https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#1
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28222641/genotyping-guided-approach-versus-the-conventional-approach-in-selection-of-oral-p2y12-receptor-blockers-in-chinese-patients-suffering-from-acute-coronary-syndrome
#2
Chor Cheung Tam, Janette Kwok, Anthony Wong, Arthur Yung, Catherine Shea, Shun Ling Kong, Wing Hong Tang, David Siu, Raymond Chan, Stephen Lee
Objective The CYP2C19 loss-of-function (LoF) allele is present in half of the East Asian population and is associated with high on-treatment platelet reactivity (HTPR). This study aimed to investigate whether a rapid genotyping-guided approach is feasible and efficacious for selecting P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome (ACS). Methods This was a single-centre, prospective, randomized, open-label study. A total of 132 patients with ACS were randomized to the rapid genotyping-guided treatment group (GG, N = 65) or the standard treatment group (SG, N = 67)...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28216475/the-effect-of-ticagrelor-administered-through-a-nasogastric-tube-to-comatose-patients-undergoing-acute-percutaneous-coronary-intervention-the-ticoma-study
#3
Hanna Ratcovich, Golnaz Sadjadieh, Hedvig B Andersson, Martin Frydland, Sebastian Wiberg, Nadia P Dridi, Jesper Kjaergaard, Lene Holmvang
AIMS: Patients in a coma after cardiac arrest may have adversely affected drug absorption and metabolism. This study, the first of its kind, aimed to investigate the early pharmacokinetic and pharmacodynamic effects of ticagrelor administered through a nasogastric tube (NGT) to patients resuscitated after an out of hospital cardiac arrest (OHCA) and undergoing primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Blood samples were drawn at baseline and at two, four, six, eight, 12, and 24 hours and then daily for up to five days after administration of a 180 mg ticagrelor loading dose (LD), followed by 90 mg twice daily in 44 patients...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28216470/crushed-ticagrelor-in-comatose-patients-treated-with-primary-percutaneous-coronary-intervention
#4
Fabiana Rollini, Francesco Franchi, Dominick J Angiolillo
No abstract text is available yet for this article.
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#5
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28213047/the-effect-of-combined-aspirin-and-clopidogrel-treatment-on-cancer-incidence
#6
Avi Leader, Ravit Zelikson-Saporta, David Pereg, Galia Spectre, Uri Rozovski, Pia Raanani, Doron Hermoni, Michael Lishner
BACKGROUND: Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data regarding the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared to aspirin alone and no antiplatelet therapy...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28203684/crushed-sublingual-versus-oral-ticagrelor-administration-strategies-in-patients-with-unstable-angina-a-pharmacokinetic-pharmacodynamic-study
#7
Piotr Niezgoda, Joanna Sikora, Malwina Barańska, Adam Sikora, Katarzyna Buszko, Emilia Siemińska, Michał Piotr Marszałł, Jolanta M Siller-Matula, Bernd Jilma, Dimitrios Alexopoulos, Tomasz Fabiszak, Jacek Kubica
Oral administration of crushed ticagrelor tablets turned out to be an efficacious method that improves its pharmacokinetics and pharmacodynamics. This strategy, however, is unlikely to eliminate the drug-drug interaction in patients receiving intravenous morphine, as the impairment of the P2Y12 inhibitor absorption related to decreased propulsive motility of the gastro-intestinal tract is the most likely mechanism of interaction. Thus, we designed a pharmacokinetic and pharmacodynamic study setting the feasibility of platelet inhibition with a loading dose of ticagrelor given as crushed tablets sublingually compared with two other ticagrelor loading dose administration strategies: integral tablet given orally and crushed tablet given orally in patients with unstable angina...
February 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28202132/comparison-of-platelet-reactivity-in-black-versus-white-patients-with-acute-coronary-syndromes-after-treatment-with-ticagrelor
#8
Michael A Gaglia, Michael J Lipinski, Thibault Lhermusier, Arie Steinvil, Sarkis Kiramijyan, Shreejana Pokharel, Rebecca Torguson, Dominick J Angiolillo, Lars Wallentin, Robert F Storey, Ron Waksman
Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#9
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28161342/excess-ticagrelor-mortality-in-the-food-and-drug-administration-adverse-event-reporting-system-time-to-recount-plato-trial-deaths
#10
EDITORIAL
Victor L Serebruany, Seth D Fortmann, Vasily Cherepanov, Oleg Litvinov, Moo Hyun Kim, Thomas A Marciniak
No abstract text is available yet for this article.
February 1, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28159767/ticagrelor-reversal-in-vitro-assessment-of-four-haemostatic-agents
#11
Leyla Calmette, Anne-Céline Martin, Bernard Le Bonniec, Diane Zlotnik, Isabelle Gouin-Thibault, Christilla Bachelot-Loza, Pascale Gaussem, Anne Godier
AIM: Management of ticagrelor-induced bleeding is challenging as platelet transfusion is ineffective. An effective strategy is needed. This study aimed to investigate in vitro the efficacy of four haemostatic drugs (HDs), namely recombinant activated factor VII (rFVIIa), fibrinogen concentrate (Fib), tranexamic acid (TXA) and factor XIII concentrate (FXIII) to improve the haemostatic capacity in the presence of ticagrelor. METHODS: Blood was spiked with ticagrelor then supplemented by either HD or control...
February 3, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28154807/hypersensitivity-to-ticagrelor-and-low-response-to-clopidogrel-a-case-report
#12
Jing Dai, Shuzheng Lyu, Changjiang Ge
Ticagrelor is widely used to treat acute coronary syndrome. Hypersensitivity reaction of ticagrelor is rarely recognized. A low response to clopidogrel, which occurs in up to 23% of patients, is an independent risk factor for stent thrombosis. Management of patients with a low response to clopidogrel and ticagrelor hypersensitivity who are undergoing antithrombotic therapy remains to be a challenge. Herein, we report a patient with low response to clopidogrel and ticagrelor hypersensitivity, who was successfully managed using aspirin and warfarin...
January 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/28150850/chewing-versus-swallowing-ticagrelor-to-accelerate-platelet-inhibitionin-acute-coronary-syndrome-the-cheers-study-for-the-platis-platelets-and-thrombosis-in-sheba-study-group
#13
Elad Asher, Shir Frydman, Moshe Katz, Ehud Regev, Avi Sabbag, Israel Mazin, Arsalan Abu-Much, Andrew Kukuy, Anna Mazo, Aharon Erez, Anat Berkovitch, Michael Narodistky, Israel Barbash, Amit Segev, Roy Beigel, Shlomi Matetzky
It was the study objective to evaluate whether chewing a 180 mg loading dose of ticagrelor versus an equal dose of traditional oral administration, enhances inhibition of platelet aggregation 1 hour (h) after administering a ticagrelor loading dose in non-ST elevation myocardial infarction (NSTEMI) patients. Dual anti-platelet therapy represents standard care for treating NSTEMI patients. Ticagrelor is a direct acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation...
February 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28150522/dyspnea-in-patients-treated-with-p2y12-receptor-antagonists-insights-from-the-greek-antiplatelet-grape-registry
#14
Dimitrios Alexopoulos, Ioanna Xanthopoulou, Angelos Perperis, John Goudevenos, Michalis Hamilos, George Sitafidis, Ioannis Kanakakis, Manolis Vavouranakis, George Giannopoulos, Nikolaos Barampoutis, Spyridon Deftereos, John Lekakis
In 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2...
February 2, 2017: Platelets
https://www.readbyqxmd.com/read/28150519/ticagrelor-pharmacokinetics-and-pharmacodynamics-in-patients-with-nstemi-after-a-180-mg-loading-dose
#15
Manne Holm, Per Tornvall, Julia Westerberg, Shaym Rihan Hye, Jan van der Linden
The pharmacokinetics after a 180-mg loading dose (LD) of ticagrelor has not been thoroughly investigated in NSTEMI patients. We aimed to compare the ticagrelor uptake and on-treatment platelet reactivity between non-ST-segment elevation myocardial infarction (NSTEMI) patients and a control group of patients with stable coronary artery disease (SCAD) undergoing elective percutaneous coronary intervention. We performed an observational, prospective, single-center study including 40 NSTEMI patients and 20 SCAD controls...
February 2, 2017: Platelets
https://www.readbyqxmd.com/read/28144007/ticagrelor-associated-thrombotic-thrombocytopenic-purpura
#16
Ali Doğan, Behzat Özdemir, Hamit Bal, Emrah Özdemir, Nuri Kurtoğlu
No abstract text is available yet for this article.
January 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28139972/population-pharmacokinetics-of-ticagrelor-and-ar-c124910xx-in-patients-with-prior-myocardial-infarction%C3%A2
#17
Daniel Röshammar, Martin Bergstrand, Tomas Andersson, Robert F Storey, Bengt Hamrén
OBJECTIVE: The population pharmacokinetics of ticagrelor and its active metabolite AR-C124910XX were characterized following ticagrelor 60 mg or 90 mg twice daily oral long-term treatment in 4,426 patients with a history of myocardial infarction. METHODS: The ticagrelor and AR-C124910XX plasma concentration-time data were described by one-compartment models with first-order absorption or metabolite formation and elimination. RESULTS: Systemic exposure to ticagrelor and AR-C124910XX were stable over time...
January 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28139897/oral-antiplatelet-agents-for-the-management-of-acute-coronary-syndromes-a-review-for-nurses-and-allied-healthcare-professionals
#18
REVIEW
Tania Gesheff, Cescelle Barbour
PURPOSE: We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES: Treatment guidelines and clinical articles from PubMed. CONCLUSIONS: Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response...
January 31, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28134127/impact-of-presentation-and-transfer-delays-on-complete-st-segment-resolution-before-primary-percutaneous-coronary-intervention-insights-from-the-atlantic-trial
#19
Enrico Fabris, Arnoud Van't Hof, Christian W Hamm, Frédéric Lapostolle, Jens Flensted Lassen, Shaun G Goodman, Jurriën M Ten Berg, Leonardo Bolognese, Angel Cequier, Mohamed Chettibi, Christopher J Hammett, Kurt Huber, Magnus Janzon, Béla Merkely, Robert F Storey, Uwe Zeymer, Warren J Cantor, Hélène Rousseau, Eric Vicaut, Gilles Montalescot
AIMS: To identify predictors of complete ST-segment resolution (STR) pre-primary percutaneous coronary intervention (PCI) in patients enrolled in the ATLANTIC trial. METHODS AND RESULTS: ECGs recorded at the time of inclusion [pre-hospital (pre-H)-ECG] and in the catheterization laboratory before angiography (pre-PCI-ECG) were analysed by an independent core laboratory. Complete STR was defined as ≥70%. Complete STR occurred pre-PCI in 12.8% (204/1598) of patients and predicted lower 30-days composite MACCE (OR=0...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28122793/real-world-insights-on-the-initiation-and-treatment-duration-of-oral-antiplatelets-in-acute-coronary-syndromes-a-retrospective-cohort-study
#20
Marc J Claeys, Christophe Beauloye, Suzanne Pourbaix, Peter R Sinnaeve
AIMS: This study is a real world, observational study evaluating the treatment persistence of oral antiplatelet (OAP) therapy during a one-year follow-up in patients after an acute coronary syndrome (ACS). METHODS AND RESULTS: Data on diagnosis, comorbidities, follow-up, OAP treatment, reasons, and decision maker for treatment discontinuation in patients who were discharged from a hospital in Belgium after an ACS between 1 July 2012 and 1 June 2013 were collected by cardiologists from 18 centres, up to 360 days from discharge...
January 24, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
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