One-Month Outcomes of Cases Receiving Ticagrelor after Percutaneous Coronary Intervention; a Case Series
Archives of Academic Emergency Medicine,
Vol. 8 No. 1 (2020),
7 January 2020
Introduction: Ticagrelor is the first reversibly binding oral P2Y12 receptor antagonist that can block ADP-induced platelet aggregation. This study aimed to describe one-month follow-up findings of cases undergoing ticagrelor therapy after percutaneous coronary intervention (PCI).
Methods: This case series was performed on acute coronary syndrome (ACS) patients who were candidates for PCI and received aspirin plus ticagrelor after PCI. Patients were followed for one month and their outcomes were described. Â
Results: 156 cases with the mean age of 59.74 Â± 9.24 years were studied (63% male). 45 (28.8%) cases complained of dyspnea (39 cases with mild and 6 cases with severe dyspnea). Bleeding occurred in 4 (2.5%) cases (intra-cranial hemorrhage (ICH) in one, hematuria in two, and skin hemorrhage in one case). There were no cases with bradycardia or thrombosis. One (0.6%) patient developed drug hypersensitivity reaction, which manifested as skin rash. The use of drug was stopped in 10 (6.4%) cases due to severe dyspnea (n= 6), ICH (n=1), skin rash (n=1), and concomitant left ventricular (LV) clot (n=2).Â
Conclusion: The most important finding of one-month ticagrelor consumption were dyspnea, bleeding, and hypersensitivity reaction. No case of bradycardia and stent thrombosis was detected.Â The rate of drug discontinuation in this series of cases was 6.4 %.
- patient outcome assessment
- drug-related side effects and adverse reactions
- percutaneous coronary intervention
- platelet aggregation inhibitors
How to Cite
Park J, Min J, Kang J, In Y. Acute myocardial infarction due to stent thrombosis after administration of intravenous epinephrine for anaphylaxis. Chinese medical journal. 2015;128(19).
TyczyÅ„ski P, Karcz MA, KaliÅ„czuk Å, Fronczak A, Witkowski A. Early stent thrombosis. Aetiology, treatment, and prognosis. PostÄ™py w Kardiologii Interwencyjnej= Advances in Interventional Cardiology. 2014;10(4):221.
Rademakers L, Dewilde W, van de Kerkhof D. Early double stent thrombosis associated with clopidogrel hyporesponsivenesss. Netherlands Heart Journal. 2012;20(1):38-41.
Olechowski B, Ashby A, Sambu N, Mahmoudi M, Curzen N. Stent thrombosis patients with hyporesponsiveness to clopidogrel, prasugrel, and ticagrelor: a case series using short thromboelastography. Case reports in medicine. 2016;2016.
Jariwala P, Bhatia H, Kumar EAP. Sub-acute stent thrombosis secondary to ticagrelor resistanceâ€”Myth or reality!! Indian heart journal. 2017;69(6):804.
Fan Z-G, Zhang W-L, Xu B, Ji J, Tian N-L, He S-H. Comparisons between ticagrelor and clopidogrel following percutaneous coronary intervention in patients with acute coronary syndrome: a comprehensive meta-analysis. Drug design, development and therapy. 2019;13:719.
Volney C, Collins A, Adams S. Ticagrelor versus clopidogrel in the management of acute myocardial infarction. Journal of community hospital internal medicine perspectives. 2019;9(4):314-8.
Husted S, Van Giezen J. Ticagrelor: the first reversibly binding oral P2Y12 receptor antagonist. Cardiovascular therapeutics. 2009;27(4):259-74.
Dimitrova G, Tulman D, Bergese S. Perioperative management of antiplatelet therapy in patients with drug-eluting stents. HSR proceedings in intensive care & cardiovascular anesthesia. 2012;4(3):153.
Akhlaghi A, Shirani S, Ziaie N, Pirhaji O, Yaran M, Shahverdi G, et al. Cytochrome P450 2C19 polymorphism in Iranian patients with coronary artery disease. ARYA atherosclerosis. 2011;7(3):106.
Reejhsinghani R, Lotfi AS. Prevention of stent thrombosis: challenges and solutions. Vascular health and risk management. 2015;11:93.
Bergmeijer TO, van Oevelen M, Janssen PW, Godschalk TC, Lichtveld RA, Kelder JC, et al. Safety of Ticagrelor Compared to Clopidogrel after Prehospital Initiation of Treatment. TH Open. 2018;2(04):e357-e68.
Goel D. Ticagrelor: The first approved reversible oral antiplatelet agent. International Journal of Applied and Basic Medical Research. 2013;3(1):19.
Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. New England Journal of Medicine. 2009;361(11):1045-57.
Wallentin L, James S, Storey RF, Armstrong M, Barratt BJ, Horrow J, et al. Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial. The Lancet. 2010;376(9749):1320-8.
Levin L-Ã…, Wallentin L, Bernfort L, Andersson D, Storey RF, BergstrÃ¶m G, et al. Health-related quality of life of ticagrelor versus clopidogrel in patients with acute coronary syndromesâ€”results from the PLATO trial. Value in health. 2013;16(4):574-80.
Kang H-J, Clare RM, Gao R, Held C, Himmelmann A, James SK, et al. Ticagrelor versus clopidogrel in Asian patients with acute coronary syndrome: a retrospective analysis from the Platelet Inhibition and Patient Outcomes (PLATO) Trial. American heart journal. 2015;169(6):899-905. e1.
- Abstract Viewed: 70 times
- PDF Downloaded: 43 times
- HTML Downloaded: 17 times