Ticagrelor overcomes high platelet reactivity in patients with acute myocardial infarction or coronary artery in-stent restenosis: a randomized controlled trial

Scientific Reports
Pan LiLiping Ma

Abstract

High on-treatment platelet reactivity (HTPR) is accompanied by an increased risk of adverse outcomes. Direct comparison of the antiplatelet effects between ticagrelor and high-dose clopidogrel has not yet been reported in acute myocardial infarction (AMI) or coronary artery in-stent restenosis (ISR) patients with HTPR. Consecutive patients with AMI or coronary artery ISR treated with standard-dose clopidogrel (75 mg/day) were screened with the VerifyNow assay, defining HTPR as P2Y12 reaction units (PRUs)>208. Of the 102 screened patients, 48 (47.06%) patients with HTPR were randomly assigned to either ticagrelor (180 mg/90 mg twice daily) or high-dose clopidogrel (150 mg/day) for 24 hours. Baseline characteristics and mean PRUs were similar in both groups. After 24 hours, ticagrelor was associated with a significantly lower platelet reactivity than high-dose clopidogrel (44.38±40.26  vs. 212.58±52.34 PRU, P<0.05). No patient receiving ticagrelor exhibited HTPR, whereas 15 (62.50%) patients after treatment with high-dose clopidogrel remained HTPR (P<0.05). During the follow-up (mean, 138.42±53.59 days), no patient exhibited a major bleeding event in either treatment group. In conclusion, in patients with AMI or coronary artery I...Continue Reading

References

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Citations

Mar 1, 2018·Current Treatment Options in Cardiovascular Medicine·Daniel R MangelsTaisei Kobayashi
Sep 19, 2019·Journal of Community Hospital Internal Medicine Perspectives·Candice VolneySarah Adams
Sep 4, 2018·JACC. Basic to Translational Science·Travis R SextonSusan Smyth
Jun 30, 2019·Current Cardiology Reviews·Habib HaybarNajmaldin Saki

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Software Mentioned

SPSS
VerifyNow

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