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Ticagrelor: the first novel reversible P2Y(12) inhibitor
Wah Wah Htun1, Steven R Steinhubl
1Geisinger Medical Center, Department of Cardiology, Danville Pennsylvania, 100N Academy Ave, MC 27-70, Danville, PA 17822, USA.
Expert Opinion on Pharmacotherapy
|December 28, 2012
Summary
Ticagrelor, a P2Y12 inhibitor, offers superior efficacy and comparable safety to clopidogrel for acute coronary syndrome (ACS) patients. It is the only intervention besides aspirin to show a cardiovascular mortality benefit within one year for ACS.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Dual antiplatelet therapy is standard for acute coronary syndrome (ACS).
- Guidelines recommend aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, ticagrelor) for ACS management.
- Ticagrelor represents a new class of reversible P2Y12 inhibitors.
Purpose of the Study:
- To review studies evaluating ticagrelor's pharmacokinetics, pharmacodynamics, efficacy, and safety.
- To compare ticagrelor with existing antiplatelet agents in ACS patients.
Main Methods:
- Review of clinical studies on ticagrelor.
- Comparative analysis of ticagrelor versus other antiplatelet therapies.
- Evaluation of pharmacokinetic and pharmacodynamic profiles.
Main Results:
- Ticagrelor (180 mg loading, 90 mg b.i.d.) is more efficacious than clopidogrel in ACS patients.
- Ticagrelor demonstrates comparable safety to clopidogrel.
- Ticagrelor is the only intervention besides aspirin to show a 1-year cardiovascular mortality benefit in a broad ACS population.
Conclusions:
- Ticagrelor offers significant efficacy and safety advantages for ACS treatment.
- Ticagrelor provides a unique cardiovascular mortality benefit in ACS patients.
- Further research is investigating ticagrelor's benefits in other populations.
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