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  4. Brief Report

卷 8 编号 1 (2020)

十月 2020

One-Month Outcomes of Cases Receiving Ticagrelor after Percutaneous Coronary Intervention; a Case Series

  • Mohammad Hasan Namazi
  • Farzam Saemifard
  • Mehdi Pishgahi

学术急诊医学档案, 卷 8 编号 1 (2020), 1 十月 2020 , 第 e42 页
https://doi.org/10.22037/aaem.v8i1.649 已出版: 2020-04-04

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摘要

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.  

Results: 156 cases with the mean age of 59.74 ± 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). 

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.  The rate of drug discontinuation in this series of cases was 6.4 %.

关键词:
  • Ticagrelor
  • patient outcome assessment
  • drug-related side effects and adverse reactions
  • percutaneous coronary intervention
  • platelet aggregation inhibitors
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Namazi MH, Saemifard F, Pishgahi M. One-Month Outcomes of Cases Receiving Ticagrelor after Percutaneous Coronary Intervention; a Case Series. Arch Acad Emerg Med [网际网络]. 2020年4月4日 [见引于 2026年7月7日];8(1):e42. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/649
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参考

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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.

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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 resistance—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.

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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.

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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-Å, Wallentin L, Bernfort L, Andersson D, Storey RF, Bergström G, et al. Health-related quality of life of ticagrelor versus clopidogrel in patients with acute coronary syndromes—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.

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