title: Comparison of half- and standard-dose ticagrelor in Chinese patients with NSTE-ACS.
abstract: Ticagrelor is a novel direct-acting P2Y12 receptor antagonist used for preventing atherothrombotic events in patients with acute coronary syndromes (ACS). The current recommended dose is 90 mg bid, but a low dose of ticagrelor has not been previously studied in Chinese ACS patients. Therefore, we performed this study to observe the different effects of half- and standard-dose ticagrelor on platelet aggregation in Chinese patients with NSTE-ACS. Sixty-two NSTE-ACS subjects were assigned to half-dose ticagrelor (n = 20), standard-dose ticagrelor (n = 22) and clopidogrel (n = 20) groups. Five days after drug administration, VerifyNow P2Y12 assay was performed to test P2Y12 reaction units (PRU) and inhibition of platelet aggregation (IPA). High-platelet reactivity (HPR) was defined as a PRU > 208. The adverse events, including bleeding events and dyspnoea, were monitored throughout the study. PRU values in the half-dose (44.55 ± 32.88) and standard-dose (39.10 ± 40.02) ticagrelor were dramatically lower than those in the clopidogrel group (189.20 ± 65.22; P < 0.0001). The half-dose (84% ± 10%) and standard-dose (86% ± 13%) ticagrelor both showed greater IPA than clopidogrel (33% ± 20%; P < 0.0001). There were no significant differences in PRU and IPA between the two ticagrelor groups (P = 0.3085 and 0.4028, respectively). HPR rates were significantly lower in the two ticagrelor groups (0% for both) than those in the clopidogrel group (35%). In conclusion, half-dose ticagrelor had a similar inhibitory effect on platelet aggregation as standard-dose ticagrelor in Chinese patients with NSTE-ACS, which was significantly stronger than that of clopidogrel.
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: H J
authors.initials: HJ
authors.lastname: Xue
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: J
authors.initials: J
authors.lastname: Shi
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: B
authors.initials: B
authors.lastname: Liu
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: D Y
authors.initials: DY
authors.lastname: Wang
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Z X
authors.initials: ZX
authors.lastname: Dong
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: H
authors.initials: H
authors.lastname: Guo
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Kong
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: L
authors.initials: L
authors.lastname: Sheng
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Q
authors.initials: Q
authors.lastname: Shao
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: D H
authors.initials: DH
authors.lastname: Sun
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Pan
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: X W
authors.initials: XW
authors.lastname: Dong
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Li
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Xue
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Zhou
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: H P
authors.initials: HP
authors.lastname: Yang
authors.affiliation: a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000368:Aged; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D010979:Platelet Function Tests; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D000077486:Ticagrelor; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000077486:Ticagrelor; D000241:Adenosine
keywords: Chinese patients; NSTE-ACS; VerifyNow; half-dose ticagrelor; inhibition of platelet aggregation