May 30, 2013

Ticagrelor: pros and cons

 PROS  AND  CONS  OF TICAGRELOR

 PROS 
 CONS 
VS clopidogrel
faster antiplatelet effect (rapidly absorbed reaching peak plasma concentration in 1.5 to 3 hours)

greater inhibition of platelet aggregation

reversibly bound: faster offset of effect and functional recovery of circulating platelets

reduced rate of death from vascular causes, myocardial infarction, or stroke in ACS with or without ST-segment elevation (1)
increased major bleeding unrelated to CABG (1)

twice daily (plasma half-life 6-13 hours)

cost
VS prasugrel
does not require metabolic activation by the liver (it is not a prodrug)

reversibly bound

mortality benefit in ACS (1)
twice daily (plasma half-life 6-13 hours)
ACS: acute coronary syndrome
CABG: coronary artery bypass grafting
(1) Based on PLATO