Secondary prophylaxis is essential to reduce the adverse cardiovascular outcomes post revascularization in coronary heart disease (CHD). P2Y12 inhibitors (i.e. clopidogrel, prasugrel, or ticagrelor) are effective for this purpose; however, guidelines which inhibitor prescribe differ according patient’s clinical characteristics, and trends their utilization not well studied real-world setting. T...

The P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are administered in fixed doses without laboratory monitoring. Randomized trials in acute coronary syndrome have shown that prasugrel and ticagrelor are more effective than standard-dose clopidogrel. Nonetheless, standard-dose clopidogrel remains widely used because it causes less bleeding and is less expensive. Patients treated with...

In ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) peri-procedural P2Y12 antagonism - although of great importance - is often suboptimal, even with the novel oral antiplatelet agents prasugrel and ticagrelor. The concept of pre-hospital ticagrelor loading, investigated in the recently published Administration of Ticagrelor ...

Patients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery dise...

Disaggregation as the difference between maximal and final platelet aggregation by light transmission aggregometry indicates the stability of platelet aggregates. We evaluated the extent of disaggregation after platelet stimulation with adenosine diphosphate (ADP), arachidonic acid (AA), collagen, epinephrine, and thrombin receptor-activating peptide (TRAP)-6 in 323 patients on dual antiplatele...

AIMS The GLOBAL LEADERS trial is a superiority study in patients undergoing percutaneous coronary intervention, with a uniform use of Biolimus A9-eluting stents (BES) and bivalirudin. GLOBAL LEADERS was designed to assess whether a 24-month antithrombotic regimen with ticagrelor and one month of acetylsalicylic acid (ASA), compared to conventional dual antiplatelet therapy (DAPT), improves outc...

In the current issue of the journal, Kubica and co-workers present findings of attenuated platelet inhibition by ticagrelor induced by the concomitant administration of morphine. The authors tested a 5 mg intravenous dose of morphine against placebo in 70 patients with acute myocardial infarction (AMI), followed by a 180 mg loading dose of ticagrelor. The measured parameters included ticagrelor...

Cardiovascular and cerebrovascular events commonly arise from atherosclerotic plaque rupture that produces platelet activation, thrombus formation, and reduction of blood flow to the brain or heart. The inhibition of platelets with aspirin is effective in the secondary prevention of acute coronary events.1 The addition of clopidogrel (i.e., dual antiplatelet therapy), a platelet P2Y12receptor a...

Ticagrelor is a BCS class IV drug that inhibits platelet action by reversibly binding to the P2Y12 receptor. One of major challenges faced (low solubility, low permeability) lower dissolution rate leading bioavailability. The bioavailability marketed formulation ticagrelor approximately 36%. Researchers have come up with various techniques improve II and formulations as an integral part develop...

BACKGROUND In the PLATO trial, ticagrelor was superior to clopidogrel in reducing cardiovascular events among patients with acute coronary syndrome (ACS) at the expense of increased nonfatal bleeding. Because Asian patients, when compared with non-Asian patients, are believed to be more susceptible to bleeding, we evaluated the effects of ticagrelor compared with clopidogrel in Asian (n=1,106) ...