Discontinuation of both cangrelor and ticagrelor because of severe dyspnea during primary angioplasty

Filippo, Chiara Di; Caniato, Flavia; Cappelli, Francesco; Mattesini, Alessio; Meucci, Francesco; Sori, Andrea; Stolcova, Mira; Agostini, Cecilia; Bernardo, Pasquale; Mario, Carlo Di

doi:10.2459/jcm.0000000000001042

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…This study suggested that ticagrelor therapy was associated with dyspnea more than clopidogrel [18]. Similarly, our results were broadly in line with a previous study that reported discontinuation of ticagrelor therapy because of severe dyspnea [19]. Previous analysis suggested that cessation of ticagrelor therapy due to dyspnea was prone to occur during the first year of treatment [20].…”

Section: Results Of Pharmacodynamic Studysupporting

confidence: 92%

Clopidogrel versus ticagrelor in elective percutaneous coronary intervention ‎

Salama¹,

El-Rokh²,

Mowafy³

et al. 2021

J Adv Pharm Educ Res

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Section: Results Of Pharmacodynamic Studysupporting

confidence: 92%

Clopidogrel versus ticagrelor in elective percutaneous coronary intervention ‎

Salama¹,

El-Rokh²,

Mowafy³

et al. 2021

J Adv Pharm Educ Res

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“…Real-life cases involving relatively young patients without high bleeding risk (HBR) features, like the one reported by Cesarini et al [ 48 ], should be switched to prasugrel. Meanwhile older patients with one or more HBR features, like the one reported by Di Filippo et al [ 49 ], should be switched to clopidogrel, possibly after the evaluation of the presence of loss-of-function alleles of the CYP2A19 enzyme. In all cases, these patients should be monitored for a few days after the switch while completing the diagnostic workup.…”

Section: The Role Of Adenosine In Anti-platelet Therapy Side Effectsmentioning

confidence: 99%

“…In the CHAMPION PHOENIX study, the incidence of dyspnea in patients treated with cangrelor was 1.2% (vs. 0.3% placebo group) and usually mild or moderate, leading to no discontinuation of the therapy [ 55 ]. Nevertheless, some authors have reported cases of discontinuation of both ticagrelor and cangrelor because of intense dyspnea [ 49 ].…”

Section: The Role Of Adenosine In Anti-platelet Therapy Side Effectsmentioning

confidence: 99%

Adenosine in Interventional Cardiology: Physiopathologic and Pharmacologic Effects in Coronary Artery Disease

Marchi,

Muraca,

Berteotti

et al. 2024

IJMS

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This review article focuses on the role of adenosine in coronary artery disease (CAD) diagnosis and treatment. Adenosine, an endogenous purine nucleoside, plays crucial roles in cardiovascular physiology and pathology. Its release and effects, mediated by specific receptors, influence vasomotor function, blood pressure regulation, heart rate, and platelet activity. Adenosine therapeutic effects include treatment of the no-reflow phenomenon and paroxysmal supraventricular tachycardia. The production of adenosine involves complex cellular pathways, with extracellular and intracellular synthesis mechanisms. Adenosine’s rapid metabolism underscores its short half-life and physiological turnover. Furthermore, adenosine’s involvement in side effects of antiplatelet therapy, particularly ticagrelor and cangrelor, highlights its clinical significance. Moreover, adenosine serves as a valuable tool in CAD diagnosis, aiding stress testing modalities and guiding intracoronary physiological assessments. Its use in assessing epicardial stenosis and microvascular dysfunction is pivotal for treatment decisions. Overall, understanding adenosine’s mechanisms and clinical implications is essential for optimizing CAD management strategies, encompassing both therapeutic interventions and diagnostic approaches.

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“…P2Y12 inhibitors may be associated with dyspnoea (higher incidence with cangrelor and ticagrelor than with clopidogrel), rarely leading to drug discontinuation. It has been hypothesized that dyspnoea is the effect of an increased stimulation of the A1 and A2A receptors located on bronchopulmonary nonmyelinated vagal C-fibres 36 …”

Section: Managementmentioning

confidence: 99%

“…It has been hypothesized that dyspnoea is the effect of an increased stimulation of the A1 and A2A receptors located on bronchopulmonary nonmyelinated vagal C-fibres. 36 Long-term prognosis of patients with CAD is influenced by adherence to evidence-based medical therapy. Stabile et al 37 investigated adherence to three classes of drugs, including statins, antiplatelets and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers following ACS.…”

Section: Managementmentioning

confidence: 99%