Ticagrelor: A safe option as part of triple therapy?

Clin Pract. 2020 Apr 27;10(1):1221. doi: 10.4081/cp.2020.1221. eCollection 2020 Mar 31.

Abstract

Patients with atrial fibrillation who have concurrent coronary artery disease requiring percutaneous coronary intervention are subsequently prescribed dual antiplatelet therapy and anticoagulation resulting in triple therapy (TT). Ticagrelor, a reversibly binding P2Y12 antiplatelet agent, has shown superiority to clopidogrel in prevention of ischemic events and death, but is also associated with a small increase in the incidence of intracranial bleeding. This bleeding risk may be enhanced in the setting of TT. The objective of this report is to describe a case of a 70-year-old male prescribed TT with ticagrelor and to review the current literature on the safety of ticagrelor as a part of TT.

Keywords: Cardiovascular disease (cardiology); antiplatelet therapy; clinical decision making; clinical pharmacology; triple therapy.