title: Ticagrelor: the first novel reversible P2Y(12) inhibitor.
abstract: BACKGROUND
  Dual antiplatelet therapy is a standard of care for treating patients with acute coronary syndrome (ACS). Combination therapy with aspirin and one of the P2Y(12) inhibitors (clopidogrel, prasugrel, or most recently, ticagrelor ) has been recommended by both ACC/AHA and ESC guidelines for ACS patients.
  
  
  METHODS
  Ticagrelor is the first generation of a new class of reversible P2Y(12) inhibitors, recently added to updated ACC and ESC guidelines for use in patients with ACS. The authors review the studies that evaluate the pharmacokinetics, pharmacodynamics, clinical efficacy and safety of ticagrelor in comparison to currently available antiplatelet agents.
  
  
  CONCLUSIONS
  Ticagrelor 180 mg loading dose followed by 90 mg b.i.d. is significantly more efficacious and, in general, as safe as clopidogrel in the treatment of all patients with an ACS regardless of treatment strategy. In addition, besides aspirin compared to placebo, it is the only pharmaceutical intervention shown to have a cardiovascular mortality benefit within 1 year in a broad ACS population. Whether this surprising benefit is realized in other populations is currently being tested.
authors.affiliation: Geisinger Medical Center, Department of Cardiology, Danville Pennsylvania, 100N Academy Ave, MC 27-70, Danville, PA 17822, USA.
authors.forename: Wah Wah
authors.initials: WW
authors.lastname: Htun
authors.forename: Steven R
authors.initials: SR
authors.lastname: Steinhubl
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000241:Adenosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D001241:Aspirin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000077486:Ticagrelor
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077486:Ticagrelor; D000241:Adenosine; D001241:Aspirin