Ticagrelor: a safe and effective approach for overcoming clopidogrel resistance in patients with stent thrombosis?
Stent thrombosis is a morbid complication following percutaneous coronary intervention (PCI). Dual antiplatelet therapy significantly reduces stent thrombosis risk. However, the antiplatelet response to clopidogrel - the most frequently used ADP receptor antagonist in post-PCI patients - varies among individuals. High on-treatment platelet reactivity was repeatedly associated with the risk of stent thrombosis. Ticagrelor is a novel ADP receptor blocker that has shown greater, more rapid and more consistent platelet inhibition than clopidogrel. This agent offers a unique mechanism of action, no relevant pharmacological interactions, consistent platelet inhibition, and a good safety profile. This article reviews the prospective use of ticagrelor in the treatment of stent thrombosis in acute coronary syndrome patients undergoing PCI of culprit coronary lesion.
aDepartment of Internal Medicine I bNational Center of Hemostasis and Thrombosis, Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
Matej
M
Samoš
Marián
M
Fedor
František
F
Kovář
Lukáš
L
Duraj
Lucia
L
Stančiaková
Peter
P
Galajda
Ján
J
Staško
Peter
P
Kubisz
Marián
M
Mokáň
D054058:Acute Coronary Syndrome / Q000473:pathology / Q000601:surgery; D000241:Adenosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D004351:Drug Resistance / Q000187:drug effects; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D018048:Receptors, Purinergic P2 / Q000378:metabolism; D015607:Stents; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D018048:Receptors, Purinergic P2; D000077144:Clopidogrel; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine