In-vivo platelet activation and aggregation during and after acute atherothrombotic myocardial infarction in patients with and without Type-2 diabetes mellitus treated with ticagrelor

Singam, Narayana Sarma V.; AlAdili, Bahjat; Amraotkar, Alok R.; Coulter, Amanda R.; Singh, Ayesha; Kulkarni, Siddhesh; Mitra, Riten; Daham, Omar Noori; Smith, Allison E.; DeFilippis, Andrew P.

doi:10.1016/j.vph.2022.107000

Cited by 1 publication

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“…These results were attributed not only to more favorable pharmacokinetics and pharmacodynamics of ticagrelor, but also partially to its pleiotropic effects, including increased plasma concentrations of adenosine [ 18 ]. Importantly, ticagrelor exerts consistent antiaggregatory and clinical effects in high-risk groups, i.e., patients with diabetes or chronic kidney disease [ 19 , 20 , 21 , 22 , 23 ].…”

Section: Ticagrelormentioning

confidence: 99%

Reversal of Platelet Inhibition in Patients Receiving Ticagrelor

Adamski¹,

Skonieczny²,

Hajdukiewicz³

et al. 2022

Rev. Cardiovasc. Med.

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Antiplatelet treatment is one of the pillars of contemporary therapy in acute coronary syndromes. It is based on dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 receptor inhibitor. Antiaggregatory treatment reduces ischemic events, but at cost of increased bleeding rates. As a result of irreversible inhibition of platelet P2Y12 receptors, the antiplatelet action of clopidogrel and prasugrel is prolonged for the lifespan of thrombocytes and lasts up to 7 days. The antiaggregatory effect of ticagrelor may persist up to 5 days despite its reversible nature of P2Y12 receptor inhibition. These pharmacodynamic properties may prove problematic in patients requiring immediate reversal of antiplatelet effects due to severe or life-threatening bleeding, or in presence of indications for an urgent surgery. The current review summarizes available knowledge on different strategies of restoring platelet function in patients treated with ticagrelor. Non-specific methods are discussed, including platelet transfusion, human albumin supplementation and hemadsorption. Finally, bentracimab, the first specific antidote for ticagrelor, and in fact against any antiplatelet agent, is described.

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