Author + information
- Elad Ashera,b,
- Shir Tala,b,
- Israel Mazina,b,
- Moshe Katza,b,
- Avi Sabbaga,b,
- Ehud Regeva,b,
- Victor Guettaa,b,
- Amit Segeva,b,
- Dan Eliana,b,
- Israel Barbasha,b,
- Paul Fefera,b,
- Roy Beigela,b and
- Shlomi Matetzkya,b
Background: Dual antiplatelet therapy represents the standard of care for the treatment of patients with ST elevation myocardial infarction (STEMI). Ticagrelor is a direct acting P2Y12 blocker and does not require metabolic activation. Hence, we aimed to evaluate whether chewing Ticagrelor 180 mg loading dose (LD) versus traditional oral administration of equal dose enhances platelet inhibition at 0.5 and 1 hours after LD administration in STEMI patients.
Methods: Forty-five STEMI patients were randomized to either chewing Ticagrelor 180 mg LD (22 patients) or standard oral administration of equal dose (23 patients). P2Y12 reaction units (PRU's) were evaluated using VerifyNow at baseline, 0.5, 1 and 4 h post LD. Patients were then continued with standard oral Ticagrelor 90 mg bid.
Results: Baseline characteristics did not differ between groups. PRU's in the chewing group compare with the standard group at 0, 0.5, 1 and 4 h after LD were 224 vs. 217 (p=0.26), 166 vs. 228 (p=0.003), 108 vs. 180 (p=0.005) and 41 vs. 50 (p=0.3) respectively, corresponding to a relative platelet reactivity inhibition of 25% vs. −9% (p= 0.001) at 0.5h, 49% vs. 10% (p=0.005) at 1 hour and 81% vs. 76% (p=0.24) at 4 hours (Figure 1). Major adverse cardiac and cardiovascular event (MACCE) rate at 30-day was low (2.2%) and occurred in only one patient in the standard group (p=1.0).
Conclusions: Chewing 180 mg Ticagrelor LD in STEMI patients is feasible and allows a better early platelet inhibition as compared with standard oral LD.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 12:30 p.m.-12:40 p.m.
Session Title: Anti-Platelet Therapies: Always a Sticky Topic
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1227M-03
- 2017 American College of Cardiology Foundation