Comparison of half- and standard-dose ticagrelor in Chinese patients with NSTE-ACS

• Published in: Platelets (Edinburgh) 2016-07, Vol.27 (5), p.440-445
• Main Authors: Xue, H. J., Shi, J., Liu, B., Wang, D. Y., Dong, Z. X., Guo, H., Kong, Y. H., Sheng, L., Shao, Q., Sun, D. H., Zhang, L., Pan, Y. J., Dong, X. W., Li, J. Q., Xue, J. Y., Zhou, Y. Y., Yang, H. P., Li, Y.
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - drug therapy; Adenosine - administration & dosage; Adenosine - adverse effects; Adenosine - analogs & derivatives; Aged; Blood Platelets - drug effects; Blood Platelets - metabolism; Chinese patients; Comorbidity; Electrocardiography; Female; half-dose ticagrelor; Humans; inhibition of platelet aggregation; Male; Middle Aged; NSTE-ACS; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - adverse effects; Platelet Function Tests; Purinergic P2Y Receptor Antagonists - administration & dosage; Purinergic P2Y Receptor Antagonists - adverse effects; Risk Factors; Treatment Outcome; VerifyNow
• ISSN: 0953-7104; 1369-1635
• DOI: 10.3109/09537104.2015.1135890

Ticagrelor is a novel direct-acting P2Y 12 receptor antagonist used for preventing atherothrombotic events in patients with acute coronary syndromes (ACS). The current recommended dose is 90 mg bid, but a low dose of ticagrelor has not been previously studied in Chinese ACS patients. Therefore, we performed this study to observe the different effects of half- and standard-dose ticagrelor on platelet aggregation in Chinese patients with NSTE-ACS. Sixty-two NSTE-ACS subjects were assigned to half-dose ticagrelor (n = 20), standard-dose ticagrelor (n = 22) and clopidogrel (n = 20) groups. Five days after drug administration, VerifyNow P2Y 12 assay was performed to test P2Y 12 reaction units (PRU) and inhibition of platelet aggregation (IPA). High-platelet reactivity (HPR) was defined as a PRU > 208. The adverse events, including bleeding events and dyspnoea, were monitored throughout the study. PRU values in the half-dose (44.55 ± 32.88) and standard-dose (39.10 ± 40.02) ticagrelor were dramatically lower than those in the clopidogrel group (189.20 ± 65.22; P < 0.0001). The half-dose (84% ± 10%) and standard-dose (86% ± 13%) ticagrelor both showed greater IPA than clopidogrel (33% ± 20%; P < 0.0001). There were no significant differences in PRU and IPA between the two ticagrelor groups (P = 0.3085 and 0.4028, respectively). HPR rates were significantly lower in the two ticagrelor groups (0% for both) than those in the clopidogrel group (35%). In conclusion, half-dose ticagrelor had a similar inhibitory effect on platelet aggregation as standard-dose ticagrelor in Chinese patients with NSTE-ACS, which was significantly stronger than that of clopidogrel.