Ticagrelor use and practice patterns among Canadian cardiac surgeons

Area of Science:

• Cardiology
• Pharmacology
• Surgical Practice

Background:

• Ticagrelor, a P2Y12 platelet inhibitor, is crucial for acute coronary syndromes and stenting.
• Bentracimab is an investigational monoclonal antibody for ticagrelor reversal.

Purpose of the Study:

• To assess cardiac surgeons' knowledge, attitudes, and practices regarding perioperative ticagrelor management.
• To evaluate the potential use of a ticagrelor reversal agent.

Main Methods:

• A questionnaire was developed and distributed to Canadian cardiac surgeons.
• Inquired about practices and beliefs concerning ticagrelor and reversal agents.

Main Results:

• Bleeding risk is the primary concern (90%) in ticagrelor-treated patients undergoing surgery.
• Variability exists in ticagrelor withholding duration; 44.3% wait 3 days, 32.9% wait longer.
• Nearly half (47.1%) knew of a reversal agent, and 91.4% would consider its use; 51.4% see it as a major advance.

Conclusions:

• Ticagrelor-related bleeding is a significant concern for cardiac surgeons.
• A substantial unmet need exists for a ticagrelor reversal agent.