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Ticagrelor: clinical development and future potential
Rev Cardiovasc Med. 2021 Jun 30;22(2):373-394. doi: 10.31083/j.rcm2202044.ABSTRACTPlatelets participate centrally in atherothrombosis, resulting in vessel occlusion and ischaemia. Consequently, optimisation of antiplatelet regimens has the potential to further reduce the residual burden of morbidity and mortality associated with atherosclerosis. Ticagrelor is a potent oral platelet P2Y12 receptor antagonist that (1) inhibits a central amplification pathway of platelet activation directly as well as via an active metabolite, (2) has a rapid onset and offset of antiplatelet action that remains consistent in the circulation d...
Source: Reviews in Cardiovascular Medicine - July 14, 2021 Category: Cardiology Authors: Nicholas C Sanderson William A E Parker Robert F Storey Source Type: research

Ticagrelor or aspirin after coronary artery bypass in patients with chronic kidney disease
CONCLUSIONS: In patients with CKD and CABG, those who received ticagrelor had a higher incidence of MACCE but a similar incidence of major bleeding compared to those who received aspirin.PMID:33819474 | DOI:10.1016/j.athoracsur.2021.03.061
Source: The Annals of Thoracic Surgery - April 5, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Sigrid E Sandner Heribert Schunkert Adnan Kastrati Milan Milojevic Andreas B öning Daniel Zimpfer Stephan Zellmer Dominik Wiedemann G ünther Laufer Moritz von Scheidt TiCAB Investigators Source Type: research

Risks and benefits of concurrent treatment with antiplatelet and anticoagulation therapy in post ‐op bioprosthetic aortic valve replacement patients
ConclusionPatients who underwent bAVR and were discharged on concurrent therapy compared to aspirin only had a significantly increased risk of bleeding without a significant difference in thromboembolic events.
Source: Journal of Cardiac Surgery - February 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carma Yaghi, Rajeev Masson, Kyoko Yamada, Shiyun Zhu, Christine Fong, Aida Shirazi, Paul LaPunzina, Kenny Mok Tags: ORIGINAL ARTICLE Source Type: research

Net Adverse Clinical Events With Antiplatelet Therapy in Acute Coronary Syndromes
Clopidogrel, prasugrel, and ticagrelor are oral platelet P2Y12 receptor inhibitors that decrease the risk of platelet-mediated coronary artery thrombosis. Clinical guidelines have recommended ticagrelor or prasugrel over clopidogrel in combination with aspirin as dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS), whether or not percutaneous coronary intervention (PCI) is performed. The ticagrelor recommendation was based on the Study of Platelet Inhibition and Patient Outcomes (PLATO) trial, which enrolled 18  624 patients with ACS and randomized them to receive DAPT with either clopidogrel ...
Source: JAMA - October 27, 2020 Category: General Medicine Source Type: research

The COMPASS trial: practical considerations for application after coronary artery bypass surgery
Purpose of review We review the cardiovascular outcomes for people using anticoagulation strategies (COMPASS) trial with particular emphasis on patients with a history of remote coronary artery bypass grafting (CABG) and those who were enrolled 4–14 days after CABG. We provide practical guidance for selecting patients with the greatest potential to benefit who have acceptable bleeding risk. In particular, we address concerns about postoperative bleeding and discuss the relative merits of rivaroxaban and aspirin versus P2Y12 inhibition and aspirin. Recent findings The COMPASS trial demonstrated that rivaroxaban and a...
Source: Current Opinion in Cardiology - August 13, 2020 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Bobby Yanagawa and Subodh Verma Source Type: research

Efficacy and Safety of Potent Oral P2Y 12 Inhibitors in Medically Managed ACS Patients: a Meta-analysis
ConclusionPotent oral P2Y12 inhibitors, especially ticagrelor, decrease the risk of ischemic events in MMACS patients as compared with clopidogrel, without significantly increasing major bleeding.
Source: Cardiovascular Drugs and Therapy - January 31, 2020 Category: Cardiology Source Type: research

Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events
CONCLUSION: Platelet aggregability, coagulation and endogenous fibrinolysis showed similar results among CAD patients with and without previous IS/TIA. Therefore, it remains necessary to identify other targets to explain the higher bleeding risk presented by these patients.
Source: Clinics - September 26, 2019 Category: General Medicine Source Type: research

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. T...
Source: The Lancet - September 2, 2019 Category: General Medicine Source Type: research

Not Just Acid Reflux: The Need to Think Worst First
Discussion Heart disease is the leading cause of death in the United States.1 This year, 720,000 Americans will have a new coronary event—defined as first hospitalized myocardial infarction (MI) or coronary heart disease death—and around 335,000 will have a recurrent event. Approximately 35% of people who experience a coronary event in a given year and around 14% of patients who have an acute coronary syndrome will die from it.1 Roughly 60% of patients with an acute coronary syndrome are transported to the emergency department via ambulance.2–4. Up to one-third of patients experiencing an MI may not complain of chest...
Source: JEMS Special Topics - January 13, 2019 Category: Emergency Medicine Authors: Stephen Sanko, MD, FACEP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

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