Ticagrelor Inhibits Adenosine Uptake In Vitro and Enhances Adenosine-Mediated Hyperemia Responses in a Canine Model

Giezen, J.J.J. van; Sidaway, James E.; Glaves, Philip; Kirk, Ian P.; Björkman, Jan-Arne

doi:10.1177/1074248411410883

Cited by 184 publications

(151 citation statements)

References 39 publications

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“…A ticagrelor-induced blockage of adenosine re-uptake into red blood cells has been suggested as the underlying basic mechanism for dyspnoea, bradycardia, and elevated creatinine or uric acid levels. 26 Pre-specified subgroup analyses also confirmed the beneficial effect of ticagrelor over the comparator clopidogrel. In the 7544 patients with STEMI referred for primary PCI, the effects of ticagrelor were consistent with those seen in the overall PLATO trial: 27 ticagrelor reduced the primary combined efficacy endpoint by 13% (9.4% vs. 10.8%, p=0.07) and the rate of a recurrent myocardial infarction was 19% lower compared to clopidogrel (4.7% vs. 5.8%, p=0.07), in both instances, however, not to a significant extent.…”

Section: Ticagrelormentioning

confidence: 62%

“…24 patients with dyspnoea, indicating that it is a benign sideeffect and that the benefit of ticagrelor as seen in the overall trial translates to patients with shortness of breath as well. 26 Furthermore, in ticagrelor-treated patients bradycardia (4.4% vs. 4.0%, p=0.21) and asymptomatic ventricular pauses of >3 seconds (5.8% vs. 3.6%, p=0.01) were more frequently reported in the first week of treatment. In addition, a small increase in creatinine and uric acid levels was observed, which subsided after treatment discontinuation at the end of the trial.…”

Section: Ticagrelormentioning

confidence: 98%

See 1 more Smart Citation

Oral antiplatelet therapy in acute coronary syndromes: update 2012

Höchtl

Sinnaeve²,

Adriaenssens³

et al. 2012

European Heart Journal: Acute Cardiovascular Care

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Dual antiplatelet therapy (DAPT), usually consisting of clopidogrel and acetylsalicylic acid (ASA), has come into discussion in recent years due to an increasing number of major adverse cardiac events based on insufficient ADP-mediated platelet inhibition with clopidogrel, mainly explained by drug interactions or genetic variants slowing or hindering the bioactivation of the prodrug clopidgrel into an active metabolite. Accordingly, new antiplatelet agents like prasugrel and ticagrelor were investigated in large prospective randomized clinical trials in patients with different entities of acute coronary syndromes (ACS). Based on their beneficial results in comparison to clopidogrel, these agents have found their way into the recent international guidelines for treatment of patients with acute coronary syndromes. Both antiplatelet agents demonstrated superiority with respect to the primary composite endpoint (cardiovascular death/non-lethal myocardial infarction/ stroke). Ticagrelor even exhibited a mortality benefit over the comparator, but both compounds also increased the risk of spontaneous major bleedings to a significant extent. However, the efficacy/safety ratio of prasugrel and ticagrelor compared to clopidogrel is better. This article widens the insight into the recent changes in antiplatelet therapy in ACS by discussing the clinically most important data derived from the TRITON-TIMI 38 trial and the PLATO trial, including also the retrospective and pre-defined subgroup analyses. This article also gives information about the recommended duration of DAPT and the situation when patients who need permanent anticoagulation (e.g. in case of non-valvular atrial fibrillation) deserve also DAPT after coronary stenting ('triple therapy').

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Section: Ticagrelormentioning

confidence: 62%

Section: Ticagrelormentioning

confidence: 98%

Oral antiplatelet therapy in acute coronary syndromes: update 2012

Höchtl

Sinnaeve²,

Adriaenssens³

et al. 2012

European Heart Journal: Acute Cardiovascular Care

View full text Add to dashboard Cite

show abstract

“…11 As well as being an additional mechanism for the antiplatelet effects of ticagrelor, 12 the increase in local adenosine levels enhances adenosine-mediated coronary blood flow. [13][14][15] Guideline Update: NSTE-ACS The AHA/ACC Task Force on Practice Guidelines has published a 2014 update for the care of patients with NSTE-ACS. 6 This update replaces the relevant parts of the 2007 ACC/AHA guidelines, 4 which were revised during focused updates in 2011 16 and 2012.…”

Section: Pathophysiology Of Acs: the Role Of Plateletsmentioning

confidence: 99%

Acute Coronary Syndrome: Focus on Antiplatelet Therapy

Bobadilla

2016

Critical Care Nurse

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The American Heart Association/American College of Cardiology in 2014 published a focused update of the 2007 and 2012 guidelines for non–ST-segment elevation acute coronary syndrome (NSTE-ACS). The management of ST-segment elevation myocardial infarction (STEMI) is described in a separate guideline published in 2013. The focused updates to the guidelines contain updated recommendations for dual antiplatelet therapy, including use of the P2Y12 inhibitor ticagrelor, which was recently approved by the Food and Drug Administration. Nurses caring for patients with acute coronary syndrome must have a good understanding of the current treatment guidelines for such patients, to help ensure delivery of evidence-based care. This review article uses a case study–based approach to describe how the new guidelines affect clinical decision making when choosing appropriate antiplatelet therapy for patients with NSTE-ACS or STEMI, depending on the patient’s clinical history and presenting characteristics.

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“…ADP plasma levels increase after injury, inflammation, and ischemia-reperfusion [14] . Ticagrelor inhibits uptake of adenosine into the cell, and subsequent to this, elevated levels of endogenous adenosine decrease levels of inflammatory markers [15,16] .…”

Section: Introductionmentioning

confidence: 99%

Böbrekte İskemi-Reperfüzyon Hasarında Ticagrelor’un Etkisi: Pleiotropik Etki Geçerli Bir Faktör mü?

Bağcıoğlu¹,

Kocaaslan²,

Uslu³

et al. 2017

Kafkas Univ Vet Fak Derg

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Citation of This ArticleBağcıoğlu M, Kocaaslan R, Uslu M, Fındık Güvendi G: The effect of ticagrelor on ischemia-reperfusion injury of kidney: Is the pleiotropic effect a valid factor? Kafkas Univ Vet Fak Derg, 23 (6): 917-924, 2017. DOI: 10.9775/kvfd.2017 AbstractThe goal of this study was to determine the protective effect of ticagrelor against ischemia-reperfusion injury in the kidney of rats via histological examination, biochemical parameters, and immunohistochemical analysis. Thirty male rats were randomized into five groups. The animals received ticagrelor 5 mg/kg, 10 mg/kg and 20 mg/kg or normal saline 0.1 mL/kg (control) orally before the procedure. The shame group only had laparatomy. An ischemia-reperfusion injury was done by clamping the renal hilus. There was less malondealdehyde assay (MDA) in ticagrelor groups than the control group, and this decrease was statistically significant (P=0.001 in all ticagrelor received groups). The glutathione peroxidase (GPx) and glutathione reductase (GR) were elevated in ticagrelor groups at all doses. Similar findings were observed in all treatment groups. The 5 mg ticagrelor treated group had no changes in glomerules and tubules relative to the control group via histology. Dilated tubular structures were similar to the sham group-both at 10 and 20 mg ticagrelor. Caspas-3 and NF-KB activity was similar in ticagrelor treated groups to sham group. Our study showed that ticagrelor is an effective agent to protect kidney from renal ischemia-reperfusion injury. Ticagrelor may protect the tissues by reducing the concentration of reactive oxygen species and inducing the antioxidant system-especially with the pleiotropic effect. Keywords: Kidney, Ischemia, Reperfusion, Injury, TicagrelorBöbrekte İskemi-Reperfüzyon Hasarında Ticagrelor'un Etkisi: Pleiotropik Etki Geçerli Bir Faktör mü? ÖzetBu çalışmada, ticagrelor'un ratların böbreğinde oluşturulan iskemi-reperfüzyon hasarına karşı koruyucu etkisinin histolojik, biyokimyasal ve immünohistokimyasal yöntemler kullanılarak tanımlanması amaçlanmıştır. Bu amaçla, 30 erkek rat rastgele olarak 5 gruba ayırılmıştır. Bu hayvanlara, yapılacak işlemlerden önce ticagrelor 5 mg/kg, 10 mg/kg ve 20 mg/kg dozlarında, kontrol grubuna da 0.1 mL/kg serum fizyolojik oral olarak verilmiştir. Sham grubunda ise sadece laparatomi yapılmıştır. İskemi-reperfüzyon hasarı renal hilusun klemplenmesi yoluyla yapılmıştır. Ticagrelor verilen gruplarda saptanan malondialdehit (MDA) düzeyinin kontrol grubundan daha az olduğu ve bu düşüklüğün istatistiksel olarak anlamlı olduğu tespit edildi (tüm ticagrelor grupları için P=0.001). Glutatyonperoksidaz (GPx) ve glutatyonredüktaz (GR) düzeyleride ticagrelor verilen tüm gruplarda artmış olarak bulundu. Histopatolojik incelemelerde, tedavi verilen tüm gruplarda benzer sonuçlar gözlendi. Ancak 5 mg ticagrelor verilen grupta glomerul ve tübül yapısında kontrol grubu arasında fark olmadığı belirlendi. 10 ve 20 mg ticagrelor verilen gruplarda, sham grubuna benzer özellikte dilate tübüler yapılar olduğu gözlendi. C...

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Ticagrelor Inhibits Adenosine Uptake In Vitro and Enhances Adenosine-Mediated Hyperemia Responses in a Canine Model

Cited by 184 publications

References 39 publications

Oral antiplatelet therapy in acute coronary syndromes: update 2012

Oral antiplatelet therapy in acute coronary syndromes: update 2012

Acute Coronary Syndrome: Focus on Antiplatelet Therapy

Böbrekte İskemi-Reperfüzyon Hasarında Ticagrelor’un Etkisi: Pleiotropik Etki Geçerli Bir Faktör mü?

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