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Incidence and Causes for Early Ticagrelor Discontinuation: A "Real-World" Dutch Registry Experience

Thomas O Bergmeijer1, Paul W A Janssen, Mathijs van Oevelen

  • 1Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Cardiology
|July 12, 2017
PubMed

Insights

Early discontinuation of ticagrelor occurred in nearly a quarter of patients, primarily due to dyspnea or bleeding. This real-world data highlights key reasons for stopping this acute coronary syndrome treatment.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • The PLATO trial demonstrated ticagrelor's superiority over clopidogrel for acute coronary syndrome (ACS) patients.
  • However, adverse events like bleeding and dyspnea associated with ticagrelor may lead to early discontinuation (ETD).

Purpose of the Study:

  • To evaluate the incidence and causes of early ticagrelor discontinuation (ETD) in a real-world setting.
  • To analyze reasons for switching antiplatelet therapy in patients treated with ticagrelor.

Main Methods:

  • Retrospective single-center registry analysis of patients prescribed ticagrelor.
  • Screening for ETD and data collection via electronic patient records and telephone follow-up.

Main Results:

  • Ticagrelor was prescribed to 354 patients; follow-up data were available for 301.
  • Early discontinuation or switching occurred in 24.3% of patients within a mean follow-up of 330 days.
  • The primary reasons for ETD were dyspnea (11.6%), bleeding (3.7%), and planned major surgery (2.7%).

Conclusions:

  • Nearly a quarter of patients discontinued ticagrelor prematurely or switched therapy within one year.
  • Dyspnea and bleeding were the most frequent causes for early ticagrelor discontinuation in this real-world cohort.
Abstract

Keywords:
Acute coronary syndromeAdverse eventsAntiplatelet agents

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