open access

Vol 13, No 5 (2018)
Review Papers
Published online: 2018-12-06
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Ticagrelor antiplatelet drug as first choice in patients with acute coronary syndrome. Are there guidelines focused on dual antiplatelet therapy applied in practice in Polish patients with ACS?

Beata Wożakowska-Kapłon
DOI: 10.5603/FC.2018.0112
·
Folia Cardiologica 2018;13(5):442-449.

open access

Vol 13, No 5 (2018)
Review Papers
Published online: 2018-12-06

Abstract

Dual antiplatelet therapy, composed of aspirin plus a P2Y12-receptor antagonist, is currently the standard for the
management of acute coronary syndrome (ACS). Ticagrelor, a representative of a new group of antiplatelet agents, is
a non-competitive, direct-acting receptor antagonist. In pharmacodynamic studies, ticagrelor demonstrated faster onset
and more potent inhibition of platelet aggregation than clopidogrel. The efficacy and safety of ticagrelor vs clopidogrel
has been proven in a randomised study [(16% reduction in cardiovascular deaths, MI and strokes (hazard ratio {HR}
0.84; 95% confidence interval {CI} 0.77–0.92), 21% reduction in cardiovascular mortality (HR 0.79; 95% CI 0.69–0,91;
p = 0.001), and no statistically significant differences in major bleeds vs clopidogrel (11.6% vs 11.2%; p = 0.43)], as
well as in the RWE Swedeheart registry. According to the current guidelines of the European Society of Cardiology, the
choice of ticagrelor rather than other P2Y12 receptor inhibitors is recommended regardless of whether the initial treatment
strategy is conservative, invasive or surgery.

Abstract

Dual antiplatelet therapy, composed of aspirin plus a P2Y12-receptor antagonist, is currently the standard for the
management of acute coronary syndrome (ACS). Ticagrelor, a representative of a new group of antiplatelet agents, is
a non-competitive, direct-acting receptor antagonist. In pharmacodynamic studies, ticagrelor demonstrated faster onset
and more potent inhibition of platelet aggregation than clopidogrel. The efficacy and safety of ticagrelor vs clopidogrel
has been proven in a randomised study [(16% reduction in cardiovascular deaths, MI and strokes (hazard ratio {HR}
0.84; 95% confidence interval {CI} 0.77–0.92), 21% reduction in cardiovascular mortality (HR 0.79; 95% CI 0.69–0,91;
p = 0.001), and no statistically significant differences in major bleeds vs clopidogrel (11.6% vs 11.2%; p = 0.43)], as
well as in the RWE Swedeheart registry. According to the current guidelines of the European Society of Cardiology, the
choice of ticagrelor rather than other P2Y12 receptor inhibitors is recommended regardless of whether the initial treatment
strategy is conservative, invasive or surgery.

Get Citation

Keywords

ticagrelor, acute coronary syndrome

About this article
Title

Ticagrelor antiplatelet drug as first choice in patients with acute coronary syndrome. Are there guidelines focused on dual antiplatelet therapy applied in practice in Polish patients with ACS?

Journal

Folia Cardiologica

Issue

Vol 13, No 5 (2018)

Pages

442-449

Published online

2018-12-06

DOI

10.5603/FC.2018.0112

Bibliographic record

Folia Cardiologica 2018;13(5):442-449.

Keywords

ticagrelor
acute coronary syndrome

Authors

Beata Wożakowska-Kapłon

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