Ticagrelor: a safe and effective approach for overcoming clopidogrel resistance in patients with stent thrombosis?

Blood Coagul Fibrinolysis. 2016 Mar;27(2):117-20. doi: 10.1097/MBC.0000000000000406.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Coronary Syndrome / pathology
  • Acute Coronary Syndrome / surgery
  • Adenosine / analogs & derivatives*
  • Adenosine / therapeutic use
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism
  • Blood Platelets / pathology
  • Clopidogrel
  • Coronary Thrombosis / etiology
  • Coronary Thrombosis / pathology
  • Coronary Thrombosis / prevention & control*
  • Drug Resistance / drug effects
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Purinergic P2Y Receptor Antagonists / therapeutic use*
  • Receptors, Purinergic P2 / metabolism
  • Stents
  • Ticagrelor
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists
  • Receptors, Purinergic P2
  • Clopidogrel
  • Ticagrelor
  • Adenosine
  • Ticlopidine