Effects of different doses of ticagrelor on platelet aggregation and endothelial function in diabetic patients with stable coronary artery disease

He, Meijiao; Li, Dan; Zhang, Yingli; Sun, Danghui; Liu, Guangzhong; Pan, Yujiao; Li, Yanyan; Yin, Shuangli; Li, Yue

doi:10.1080/09537104.2018.1513479

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…The results of a previous study 23 suggested that atorvastatin calcium tablets could effectively protect vascular endothelial function, inhibit atherosclerosis and intravascular plaque formation, and maintain cardiac systole and pumping function. Additionally, one study 24 showed that ticagrelor could rapidly prevent platelet aggregation, which is the main cause of vascular endothelial and cardiomyocyte injury, and contribute to the recovery of cardiac vessels and cardiomyocytes. The myocardial infarct size in both groups was markedly reduced, with a significant reduction observed in the observation group, indicating that the combination of the two drugs results in a higher recovery efficiency and enhanced cardiac reperfusion than atorvastatin alone.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: Effects of atorvastatin and ticagrelor combination therapy on renal function and the levels of suppression of tumorigenicity 2 and interleukin-33 in patients with ST-segment elevation myocardial infarction

Zhang

Yuan

et al. 2020

J Int Med Res

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Objective We evaluated the effects of atorvastatin and ticagrelor combination therapy on renal function and the levels of suppression of tumorigenicity 2 (ST2) and interleukin 33 (IL-33) in patients with ST-segment elevation myocardial infarction (STEMI). Methods Eighty-four STEMI patients who underwent emergency percutaneous coronary intervention at our hospital from January 2015 to March 2018 were retrospectively analyzed and divided into a control group (n = 44) and an observation group (n = 40). The control group was treated with atorvastatin as routine STEMI treatment, whereas the observation group was concurrently administered ticagrelor. Results After treatment, significantly better outcomes were observed in the control group than in the observation group in terms of clinical indices, including chest pain relief, enzyme levels, duration of reperfusion-associated arrhythmia, and depression of the ST segment. Both groups exhibited improvements in cardiac ultrasound indices, whereas the observation group showed lower left ventricular end-diastolic and end-systolic diameters and higher left ventricular ejection fractions than the control group. Conclusions Atorvastatin and ticagrelor combination therapy is clinically effective and safe for STEMI patients as it reduces the degree of myocardial infarction, protects the heart and renal functions, improves inflammation, and reduces adverse cardiac event incidences.

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Section: Discussionmentioning

confidence: 99%

RETRACTED: Effects of atorvastatin and ticagrelor combination therapy on renal function and the levels of suppression of tumorigenicity 2 and interleukin-33 in patients with ST-segment elevation myocardial infarction

Zhang

Yuan

et al. 2020

J Int Med Res

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“…The present study confirms the findings of several previous pharmacodynamic studies comparing the antiplatelet effect of ticagrelor to that of clopidogrel in CCS patients. [29][30][31][32][33][34] However, the results of these previous studies could not apply directly to diabetic patients after recent PCI for CCS. For instance, in the Randomized Double-Blind Assessment of the ONSET and OFFSET of the Antiplatelet Effects of Ticagrelor Versus Clopidogrel in Patients With Stable Coronary Artery Disease (ONSET/OFFSET) and the Response to Ticagrelor in Clopidogrel Nonresponders and Responders and Effect of Switching Therapies (RESPOND) studies, although ticagrelor demonstrated greater antiplatelet effect than clopidogrel in CCS patients, only a small proportion, that is, 22% and 26%, respectively, of the enrolled patients were diabetic and none of them underwent PCI shortly before study entry.…”

Section: Second In the Prevention Of Cardiovascular Events In Patienmentioning

confidence: 94%

“…Ticagrelor has demonstrated more potent and consistent platelet inhibition as well as improved clinical outcomes compared with clopidogrel in several clinical settings. [26][27][28][29][30][31][32][33][34] However, neither the clinical efficacy nor the antiplatelet effect of ticagrelor versus clopidogrel has been investigated specifically in diabetic patients after recent PCI for CCS. Therefore, we designed the Platelet Inhibition with Ticagrelor versus Clopidogrel in Diabetic Patients After Percutaneous Coronary Intervention for Chronic Coronary Syndromes (PLATIDE-PCI) study to assess the steady-state antiplatelet effect of ticagrelor versus clopidogrel in diabetic patients after recent PCI for CCS, who currently have no clear indication for ticagrelor, but might potentially get a favorable benefit-risk ratio with more potent P2Y 12 inhibitors, such as ticagrelor.…”

Section: Introductionmentioning

confidence: 99%

Platelet Inhibition with Ticagrelor versus Clopidogrel in Diabetic Patients after Percutaneous Coronary Intervention for Chronic Coronary Syndromes

et al. 2020

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Background Clopidogrel is currently the only P2Y12 inhibitor with class I recommendation in patients after percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS). Diabetic patients have reduced therapeutic response to clopidogrel. Purpose This study assessed the antiplatelet effect of ticagrelor versus clopidogrel in diabetic patients after recent PCI for CCS. Methods Eligible patients were randomly assigned to receive ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily, in addition to aspirin 100 mg once daily for 15 days. P2Y12 reaction unit (PRU) and percent inhibition were measured by VerifyNow P2Y12 assay. High on-treatment platelet reactivity (HOPR) was defined as PRU > 208. Bleeding was assessed by the Platelet Inhibition and Patient Outcomes criteria. Cardiac ischemic events were evaluated as adverse events. Results The baseline characteristics of the patients (n = 39) were well balanced between the two groups. Both before and 2 to 4 hours after the final study dose on day 15, PRU was lower (41.3 ± 35.8 vs. 192.6 ± 49.5, p < 0.001; 36.6 ± 25.8 vs. 187.6 ± 70.9, p < 0.001), percent inhibition was higher (83.0% [70.5%, 96.0%] vs. 16.0% [0%, 25.0%], p < 0.001; 85.0% [76.0%, 96.5%] vs. 25.0% [0%, 39.0%], p < 0.001), and HOPR occurred less frequently (0% [0/20] vs. 26.3% [5/19], p = 0.020; 0% [0/20] vs. 31.6% [6/19], p = 0.008) in the ticagrelor group (n = 20) compared with the clopidogrel group (n = 19). No major or minor bleeding, or serious adverse events occurred in both groups. Conclusion Ticagrelor achieved greater peak and trough platelet inhibition than did clopidogrel in diabetic patients after recent PCI for CCS, which suggests the potential use of ticagrelor in this clinical setting.

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“…Concerning vascular function, ticagrelor has been reported to improve coronary [33,34] and peripheral arterial function [35]. In a comparative study of different doses of ticagrelor and standard-dose clopidogrel on platelet reactivity and endothelial function in diabetic patients with stable coronary artery disease, He et al demonstrated that the measurement of flow-mediated dilation (FMD) was higher in ticagrelor groups compared to baseline levels [36].…”

Section: Discussionmentioning

confidence: 99%

“…Experimental and clinical studies have described an increase in extracellular adenosine concentration associated with ticagrelor [14,33,34,[37][38][39][40][41][42]. Several studies conducted in dogs [34] or humans [33,35,36] have demonstrated that ticagrelor induced an increase in the effect of exogenous and endogenous adenosine. The mechanism by which ticagrelor induced an extracellular increase in adenosine was not described in this study.…”

Section: Discussionmentioning

confidence: 99%

Ticagrelor Prevents Endothelial Cell Apoptosis through the Adenosine Signalling Pathway in the Early Stages of Hypoxia

et al. 2020

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Background: Several studies have reported the beneficial effects of anti-platelet drugs in cardioprotection against ischaemia–reperfusion injuries. To date, no studies have focused on the indirect cytoprotective effects of ticagrelor via adenosine receptor on the endothelium. Method: By evaluating cell viability and cleaved caspase 3 expression, we validated a model of endothelial cell apoptosis induced by hypoxia. In hypoxic endothelial cells treated with ticagrelor, we quantified the extracellular concentration of adenosine, and then we studied the involvement of adenosine pathways in the cytoprotective effect of ticagrelor. Results: Our results showed that 10 µM ticagrelor induced an anti-apoptotic effect in our model associated with an increase of extracellular adenosine concentration. Similar experiments were conducted with cangrelor but did not demonstrate an anti-apoptotic effect. We also found that A2B and A3 adenosine receptors were involved in the anti-apoptotic effect of ticagrelor in endothelial cells exposed to 2 h of hypoxia stress. Conclusion: we described an endothelial cytoprotective mechanism of ticagrelor against hypoxia stress, independent of blood elements. We highlighted a mechanism triggered mainly by the increased extracellular bioavailability of adenosine, which activates A2B and A3 receptors on the endothelium.

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Effects of different doses of ticagrelor on platelet aggregation and endothelial function in diabetic patients with stable coronary artery disease

Cited by 11 publications

References 34 publications

RETRACTED: Effects of atorvastatin and ticagrelor combination therapy on renal function and the levels of suppression of tumorigenicity 2 and interleukin-33 in patients with ST-segment elevation myocardial infarction

RETRACTED: Effects of atorvastatin and ticagrelor combination therapy on renal function and the levels of suppression of tumorigenicity 2 and interleukin-33 in patients with ST-segment elevation myocardial infarction

Platelet Inhibition with Ticagrelor versus Clopidogrel in Diabetic Patients after Percutaneous Coronary Intervention for Chronic Coronary Syndromes

Ticagrelor Prevents Endothelial Cell Apoptosis through the Adenosine Signalling Pathway in the Early Stages of Hypoxia

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