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PLACE OF TICAGRELOR IN THE NEW RECOMMENDATIONS FOR THE MANAGEMENT OF PATIENTS WITH ACUTE CORONARY SYNDROME

https://doi.org/10.21518/2307-1109-2015-2-58-65

Abstract

This article presents the main results of large clinical studies that explored the efficacy and safety of antiplatelet agent, P2Y12 inhibitor, ticagrelor. The PLATO, ATLANTIC and PAGASUS-TIMI-54 studies' results formed the basis for inclusion of ticagrelor in the clinical recommendations for the management of acute coronary syndrome (ACS). These guidelines designate ticagrelor as the main drug that should be added to acetylsalicylic acid as a component of dual antiplatelet therapy (DAT) in patients with ACS. The new 2015 recommendations for the management of patients with non-ST elevation acute coronary syndrome not only give preference to tikagrelor over clopido-grel, but also make it possible for some patients with a high risk of coronary complications and low risk of bleeding to extend DAT for longer than 12 months. In addition, the article presents data on some ACS registers held in Russia to estimate the frequency of tikagrelor administration.

About the Author

A. D. Ehrlich
Bauman City Clinical Hospital № 29 of the Moscow Health Department
Russian Federation

Dr.scient.med



References

1. Libby P. Current concepts of pathogenesis of the acute coronary syndromes. Circulation, 2001. 104: 365-72.

2. ISIS-2 collaborative group. Randomised trial of intravenous streptokinase, oral aspirin, both, or nether among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet, 1988. 332 (8607): 349-360.

3. The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-Segment Elevation. NEnglJMed, 2001. 345:494-502.

4. Husted S, Emanuelsson H, Heptinstall S et al. Pharmacodynamics, pharmacokinetics, and safety of the oral reversible P2Y12 antagonist AZD6140 with aspirin in patients with atherosclerosis: a doubleblind comparison to clopidogrel with aspirin. Eur HeartJ., 2006. 27:1038-1047.

5. Gurbel PA, Bliden KP, Butler K, et al Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation, 2009. 22. 120(25): 2577-85.

6. Wallentin L, Backer RC, Budaj A, et al. Ticagrelor versus clopidorel in patients with acute coronary syndromes. NEnglJMed, 2009. 361: 1045-57.

7. Lindholm D, Varenhorst C, Cannon CP, et al. Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascular-ization: results from the PLATO trial. Eur HeartJ, 2014. 35(31): 2083-2093.

8. Steg PG, James S, Harrington RA, et al. Ticagrelor versus clopidogrel in patients with ST-elevation acute coronary syndromes intended for reperfusion with primary percutaneous coronary intervention: A Platelet Inhibition and Patient Outcomes (PLATO) trial subgroup analysis. Circulation, 2010. 122(21): 2131-41.

9. Montaescot G, van't Hof AW, Lapostolle F, et al. Prehospital ticagrelor in ST-segment elevation myocardial infarction. NEnglJMed, 2014. 371: 1016-1027.

10. Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherotrombotic events. NEnglJMed, 2006.354: 1706-17.

11. Bhatt DL, Flather MD, Hacke W, et al. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial.JAm CollCardiol, 2007.49: 1982-8.

12. Bonaca MP, Bhatt DL, Braunwald E, et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI54) Ш.Ат HeartJ, 2014.167:437-44.

13. ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment elevation. Eur HeartJ, 2011. 32, 2999-3054.

14. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur HeartJ. doi: 10.1093/eurheartj/ehv3 20.

15. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur HeartJ, 2012. 33, 2569-2619.

16. Эрлих А.Д., Мацкеплишвили С.Т., Грацианский Н.А., Бузиашвили Ю.И. и все участники московского регистра ОКС. Первый московский регистр острого коронарного синдрома: характеристика больных, лечение и исходы за время пребывания в стационаре. Кардиология, 2013. 12:4-13.

17. Zeymer U, Hochadel M, Elsaesser A, et al. Use of clopidogrel, prasugrel and ticagrelor in patients with NSTE-ACS undergoing PCI in clinical practice: results of the ALKK-PCI registry. JAm Coll Cariol, 2015. 65(10_S).


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For citations:


Ehrlich A.D. PLACE OF TICAGRELOR IN THE NEW RECOMMENDATIONS FOR THE MANAGEMENT OF PATIENTS WITH ACUTE CORONARY SYNDROME. Aterotromboz = Atherothrombosis. 2015;(2):58-65. (In Russ.) https://doi.org/10.21518/2307-1109-2015-2-58-65

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ISSN 2307-1109 (Print)
ISSN 2658-5952 (Online)