Ticagrelor for the treatment of peripheral arterial disease.
BACKGROUND
Peripheral arterial disease (PAD) is a manifestation, and marker of severity, of a generalized atherosclerotic process. Antiplatelet therapy is recommended to prevent cardiovascular events but much of the evidence to support this is drawn from studies on older drugs.


METHODS
In this review, the authors discuss the available evidence for the basis of current recommendations and review the data from Phase I to III trials on ticagrelor as a potential future treatment. This paper also reviews the properties of ticagrelor, its adverse effects, and how it differs from current recommended antiplatelet agents. As it is also more potent, a personalized approach to antiplatelet therapy may prove useful. It further highlights the additional effects of ticagrelor mediated by adenosine and their potential benefits, which may provide an explanation to its superior outcomes in trials comparing it with clopidogrel.


CONCLUSIONS
Although there is a current lack of evidence to support the use of ticagrelor in patients with PAD, its unique pleomorphic properties make it attractive for future investigations and development of similar drugs.
University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , 40 Ruskin Street, Ottawa K1Y 4W7, Ontario , Canada +1 613 761 5387 ; +1 613 761 4338 ; dso@ottawaheart.ca.
Aun-Yeong
AY
Chong
Derek Y
DY
So
D000241:Adenosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D006801:Humans; D058729:Peripheral Arterial Disease / Q000188:drug therapy* / Q000378:metabolism; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000077486:Ticagrelor
D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077486:Ticagrelor; D000241:Adenosine
adenosine; antiplatelet; atherosclerosis; peripheral arterial disease; ticagrelor