Comparison of atrial fibrillation predictors in patients with acute coronary syndrome using ticagrelor or clopidogrel

Algül, Engin; Sunman, Hamza; Dural, Muhammet; Guliyev, İlkin; Aker, Mert; Felekoğlu, Mehmet Ali; Erat, Mehmet; Tulmaç, Murat; Açıkel, Sadık; Çi̇men, Tolga

doi:10.3906/sag-1903-188

Cited by 5 publications

(7 citation statements)

References 41 publications

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“…Ticagrelor could increase the adenosine half-life and plasma concentration levels and enhance the biological effects of adenosine, which has the potential to cause atrial fibrillation (Akkaif et al, 2021). However, a cross-sectional study did not find any difference in detailed ECG and echocardiographic parameters as atrial fibrillation predictors between ticagrelor and clopidogrel groups in ACS patients (Algül et al, 2019). Therefore, it is necessary to be aware that bradycardia may be related to the use of ticagrelor.…”

Section: Discussionmentioning

confidence: 99%

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for ticagrelor

Pan,

Wang,

Zheng

et al. 2024

Front. Pharmacol.

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Background:Ticagrelor is a commonly used antiplatelet agent, but due to the stringent criteria for trial population inclusion and the limited sample size, its safety profile has not been fully elucidated.Method:We utilized OpenVigil 2.1 to query the FDA Adverse Event Reporting System database and retrieved reports by the generic name “ticagrelor” published between 1 October 2010 and 31 March 2023. Adverse drug events (ADEs) were classified and described according to the preferred terms and system organ classes in the Medical Dictionary of Regulatory Activity. Proportional reporting ratio (PRR), reporting odds ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) were used to detect signals.Results:The number of ADE reports with ticagrelor as the primary suspect drug was 12,909. The top three ADEs were dyspnea [1824 reports, ROR 7.34, PRR 6.45, information component (IC) 2.68], chest pain (458 reports, ROR 5.43, PRR 5.27, IC 2.39), and vascular stent thrombosis (406 reports, ROR 409.53, PRR 396.68, IC 8.02). The highest ROR, 630.24, was found for “vascular stent occlusion”. Cardiac arrest (137 reports, ROR 3.41, PRR 3.39, IC 1.75), atrial fibrillation (99 reports, ROR 2.05, PRR 2.04, IC 1.03), asphyxia (101 reports, ROR 23.60, PRR 23.43, IC 4.51), and rhabdomyolysis (57 reports, ROR 2.75, PRR 2.75, IC 1.45) were suspected new adverse events of ticagrelor.Conclusion:The FAERS database produced potential signals associated with ticagrelor that have not been recorded in the package inserts, such as cardiac arrest, atrial fibrillation, asphyxia, and rhabdomyolysis. Further clinical surveillance is needed to quantify and validate potential hazards associated with ticagrelor-related adverse events.

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Section: Discussionmentioning

confidence: 99%

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for ticagrelor

Pan,

Wang,

Zheng

et al. 2024

Front. Pharmacol.

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“…In the present study, we observed that the incidence of PAF was significantly higher in patients with greater MBPS values, especially over 28.6 mmHg. There are numerous studies which investigate the predictors of AF development [ 25 , 26 ]. Domenech et al reported that there was a significant relationship between nighttime BP and left atrial size and speculated that nighttime BP levels, but not office BP levels, play the most important role in left atrial remodeling and enlargement [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The relationship between morning blood pressure surge and asymptomatic episodes of paroxysmal atrial fibrillation in patients with systemic arterial hypertension

TAŞ¹,

TAŞ²,

YAVUZ³

2022

Turkish Journal of Medical Sciences

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Background/aim Hypertension is a known risk factor for developing atrial fibrillation. However, there is limited data to investigate the association between morning blood pressure surge (MBPS) and paroxysmal atrial fibrillation (PAF). We conducted the present study to determine whether there is a relationship between asymptomatic PAF and MBPS and whether MBPS may be a predictor of asymptomatic PAF episodes. Materials and methods This prospective study comprised 264 adult patients who were newly diagnosed with essential hypertension or were previously diagnosed but not receiving regular antihypertensive therapy. We evaluated the patients in 2 groups according to their 24-h electrocardiography monitoring results: group 1 included patients who exhibited PAF (n = 32, 23 females/9 males; mean age 60.2 ± 7.4 years) and group 2 included patients with no signs of PAF as a control group (n = 232, 134 females/98 males; mean age 56.9 ± 9.4 years). We calculated the MBPS as the difference between mean systolic blood pressure (SBP) in the 2 h after getting up and the minimum nocturnal SBP. Results MBPS values were significantly higher in group 1 than in group 2 (35.3 ± 7.0 vs. 22.0 ± 6.7, p < 0.001). MBPS was positively associated with left atrial diameter (LAD) (r = 0.441, p < 0.001), left ventricle mass index (LVMI) (r = 0.235, p < 0.001), the ratio of early (E) peak of mitral inflow velocity to early (Em) diastolic mitral annular velocity (E /Em) (r = 0.239, p < 0.001), 24-h mean (r = 0.270, p < 0.001) and daytime SBP (r = 0.291, p < 0.001). We determined a cut-off value for MBPS as 28.6 for predicting PAF episodes development and identified LAD and MBPS as independent risk factors for PAF. Conclusion Patients who had larger MBPS were observed to have higher PAF incidence. MBPS values may be sensitive in predicting asymptomatic episodes of paroxysmal atrial fibrillation.

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“…On multiple regression analysis, LDL, mitral regurgitation, LA dyssynchrony, Inter-atrial dyssynchrony and LAVI max were significant predictors for AF development (P value =0.046, 0.022, <0.001, <0.001, 0.008 respectively). (4) . In terms of ECG data, P-max, P-min, PWD, PR interval, P wave axis, were insignificantly different between the studied groups (P-value > 0.05).…”

Section: A) B)mentioning

confidence: 99%

“…These differences led to the hypothesis that ticagrelor has pleiotropic properties and nonplatelet directed mechanisms of action. These effects of ticagrelor have been mostly attributed to increased halflife and plasma concentration of adenosine (4) . Adenosine is a purine nucleoside primarily produced by endothelial cells.…”

Section: Introductionmentioning

confidence: 99%

Prediction of AF in ACS Patients Using Different Antiplatelets by Tissue Doppler Derived Atrial Dyssynchrony

Ebaid,

Elrabbat,

Kamel

et al. 2023

Benha Medical Journal

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Background: Acute coronary syndromes (ACS) are one of the major causes of mortality and morbidity worldwide. Current guidelines recommend dual antiplatelet therapy in patients with ACS. This study aimed to predict AF in ACS patients using ticagrelor or clopidogrel by tissue Doppler derived atrial Dyssynchrony and to assess the outcome morbidity and mortality in each group. Methods: This was an observational, case series, single center study, was carried out at coronary care unit at "Benha University hospital" on 200 patients with ACS (STEMI & NSTE-ACS), 100 of the patients used ticagrelor and the other 100 patients used clopidogrel, in the period from June 2022 to December 2022. Results: The incidence of AF was insignificantly different between the studied groups. LAVI max and Mitral regurgitation was significantly higher in New-onset AF patients (P value=0.024, 0.001 respectively). Tissue Doppler imaging data (Lateral mitral P-A' interval, septal mitral P-As interval, tricuspid P-A' interval, LA Dyssynchrony and Interatrial Dyssynchrony) were significantly higher in New-onset AF patients (P value<0.05). LA Dyssynchrony can significantly predict the incidence of AF with AUC 0.704 (95% CI: 0.636 -0.766) and P value = 0.008, at cut off value >7.792 ms, with 68.2 % sensitivity, 63.5 % specificity, 18.7 PPV and 94.2 NPV. LV GLS was significantly lower in New-onset AF patients (P value =0.035). Conclusion: Our study showed that there was no significant difference in electro-echocardiographic AF predictors such as PWD, LAVI max, left atrial dyssynchrony and interatrial dyssynchrony in ACS patients who received ticagrelor or clopidogrel.

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Comparison of atrial fibrillation predictors in patients with acute coronary syndrome using ticagrelor or clopidogrel

Cited by 5 publications

References 41 publications

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for ticagrelor

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for ticagrelor

The relationship between morning blood pressure surge and asymptomatic episodes of paroxysmal atrial fibrillation in patients with systemic arterial hypertension

Prediction of AF in ACS Patients Using Different Antiplatelets by Tissue Doppler Derived Atrial Dyssynchrony

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