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Role of ticagrelor in the treatment of coronary artery disease

Udaya S Tantry, Dean J Kereiakes, Paul A Gurbel

Ticagrelor is a reversibly binding, noncompetitive, direct-acting, orally administered P2Y12-receptor antagonist and is a credible alternative to clopidogrel in the treatment of patients with acute coronary syndrome. Ticagrelor therapy has been associated with rapid onset and faster offset of actions and greater and consistent platelet inhibition. In the Study of Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor significantly reduced the rate of the combined end point of cardiovascular death, myocardial infarction or stroke in acute coronary syndrome patients compared with clopidogrel. A major potential benefit of ticagrelor is the unprecedented reduction in mortality among acute coronary syndrome patients. An additional important observation was similar CABG-related bleeding events in ticagrelor (vs clopidogrel)-treated patients despite the fact that ticagrelor provides more potent P2Y12-receptor blockade.