Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome
BACKGROUND—Ticagrelor outperforms clopidogrel in preventing cardiovascular events in acute coronary syndrome. Despite the inclusion of a loading dose in the Platelet Inhibition and Patient Outcomes (PLATO) trial for all patients randomized to ticagrelor, it may not be necessary in patients receiving...
Gespeichert in:
| Veröffentlicht in: | Circulation. Cardiovascular interventions 2014-02, Vol.7 (1), p.104-112 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 112 |
|---|---|
| container_issue | 1 |
| container_start_page | 104 |
| container_title | Circulation. Cardiovascular interventions |
| container_volume | 7 |
| creator | Caiazzo, Gianluca De Rosa, Salvatore Torella, Daniele Spaccarotella, Carmen Mongiardo, Annalisa Giampà, Salvatore Micieli, Mariella Palella, Eleonora Gulletta, Elio Indolfi, Ciro |
| description | BACKGROUND—Ticagrelor outperforms clopidogrel in preventing cardiovascular events in acute coronary syndrome. Despite the inclusion of a loading dose in the Platelet Inhibition and Patient Outcomes (PLATO) trial for all patients randomized to ticagrelor, it may not be necessary in patients receiving ongoing clopidogrel therapy. The aim of the present study was to assess whether a ticagrelor loading dose is associated with a further platelet inhibition during the switch from clopidogrel to ticagrelor in patients with acute coronary syndrome receiving ongoing antiplatelet treatment.
METHODS AND RESULTS—Fifty patients with acute coronary syndrome receiving aspirin and clopidogrel treatment were randomly assigned to a starting dose of ticagrelor (group 1, 90 mg; group 2, 180 mg). Platelet aggregation was measured using multiple electrode aggregometry and standard light transmission aggregometry just before the switch and at 2, 6, 24, and 72 hours. No relevant difference in platelet aggregation was observed between the 2 study arms at baseline (P=0.256). Residual platelet aggregation was significantly reduced in both arms 2 hours after the first administration of ticagrelor (P |
| doi_str_mv | 10.1161/CIRCINTERVENTIONS.113.000512 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1500686798</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1500686798</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4342-232a05134d020584be7591fe0d0b4f721bf8730caada4b57bb03fc9b4aafa7a3</originalsourceid><addsrcrecordid>eNqNkcGO0zAURSMEYoaBX0BvwYJNBztxmkZiQZTpMJWqFk0jWEZO_JwYnLjYDtV8Gz-HqwyzYcPK1vW591nvRtE7Sq4pXdIP5ea-3Oyq9f3X9a7a7HeHICfXhJCUxs-iS5ozusiWSfz86c7IRfTKue-EBHkZv4wuYsZYnubZZfS7EIMalfOWe2VGMBI4bA0XauzgxjiEO-5gZ6AQQnn1C2EtJbYeAvtFc48aPRRdZ7GbA24me7b6HuFwUr7t4daaAfZjZ856qc1RCRN4DZVF7gccPXgDlWr5WTUWVIgOYeHBwTfleyjaySOUxpqR2wc4PIwiZOLr6IXk2uGbx_Mqqm7XVXm32O4_b8piu2hZwuJFnMQ8LCdhgsQkXbEGszSnEokgDZNZTBu5yhLSci44a9KsaUgi27xhnEue8eQqej_HHq35OaHz9aBci1rzEc3kapqGxa6WWb4K6McZba1xzqKsj1YN4c81JfW5vfqf9oKc1HN7wf72cdLUDCiezH_rCsCnGTgZ7dG6H3o6oa175Nr3_zfjD0pysG8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1500686798</pqid></control><display><type>article</type><title>Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Caiazzo, Gianluca ; De Rosa, Salvatore ; Torella, Daniele ; Spaccarotella, Carmen ; Mongiardo, Annalisa ; Giampà, Salvatore ; Micieli, Mariella ; Palella, Eleonora ; Gulletta, Elio ; Indolfi, Ciro</creator><creatorcontrib>Caiazzo, Gianluca ; De Rosa, Salvatore ; Torella, Daniele ; Spaccarotella, Carmen ; Mongiardo, Annalisa ; Giampà, Salvatore ; Micieli, Mariella ; Palella, Eleonora ; Gulletta, Elio ; Indolfi, Ciro</creatorcontrib><description>BACKGROUND—Ticagrelor outperforms clopidogrel in preventing cardiovascular events in acute coronary syndrome. Despite the inclusion of a loading dose in the Platelet Inhibition and Patient Outcomes (PLATO) trial for all patients randomized to ticagrelor, it may not be necessary in patients receiving ongoing clopidogrel therapy. The aim of the present study was to assess whether a ticagrelor loading dose is associated with a further platelet inhibition during the switch from clopidogrel to ticagrelor in patients with acute coronary syndrome receiving ongoing antiplatelet treatment.
METHODS AND RESULTS—Fifty patients with acute coronary syndrome receiving aspirin and clopidogrel treatment were randomly assigned to a starting dose of ticagrelor (group 1, 90 mg; group 2, 180 mg). Platelet aggregation was measured using multiple electrode aggregometry and standard light transmission aggregometry just before the switch and at 2, 6, 24, and 72 hours. No relevant difference in platelet aggregation was observed between the 2 study arms at baseline (P=0.256). Residual platelet aggregation was significantly reduced in both arms 2 hours after the first administration of ticagrelor (P<0.001 for both), with no difference in aggregation between groups (multiple electrode aggregometry, 17.6±7.2 versus 18.1±6 U; P=0.281). Similar results were observed with LTA.
CONCLUSIONS—Switching from clopidogrel to ticagrelor without a reloading dose is feasible, and it does not hinder platelet aggregation inhibition in patients with acute coronary syndrome. Further prospective studies are needed to assess the clinical relevance of our findings.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01795820.</description><identifier>ISSN: 1941-7640</identifier><identifier>EISSN: 1941-7632</identifier><identifier>DOI: 10.1161/CIRCINTERVENTIONS.113.000512</identifier><identifier>PMID: 24449597</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Acute Coronary Syndrome - drug therapy ; Adenosine - administration & dosage ; Adenosine - adverse effects ; Adenosine - analogs & derivatives ; Aged ; Drug Dosage Calculations ; Drug Substitution ; Drug Synergism ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - administration & dosage ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Function Tests ; Ticlopidine - administration & dosage ; Ticlopidine - adverse effects ; Ticlopidine - analogs & derivatives ; Treatment Outcome</subject><ispartof>Circulation. Cardiovascular interventions, 2014-02, Vol.7 (1), p.104-112</ispartof><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4342-232a05134d020584be7591fe0d0b4f721bf8730caada4b57bb03fc9b4aafa7a3</citedby><cites>FETCH-LOGICAL-c4342-232a05134d020584be7591fe0d0b4f721bf8730caada4b57bb03fc9b4aafa7a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24449597$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caiazzo, Gianluca</creatorcontrib><creatorcontrib>De Rosa, Salvatore</creatorcontrib><creatorcontrib>Torella, Daniele</creatorcontrib><creatorcontrib>Spaccarotella, Carmen</creatorcontrib><creatorcontrib>Mongiardo, Annalisa</creatorcontrib><creatorcontrib>Giampà, Salvatore</creatorcontrib><creatorcontrib>Micieli, Mariella</creatorcontrib><creatorcontrib>Palella, Eleonora</creatorcontrib><creatorcontrib>Gulletta, Elio</creatorcontrib><creatorcontrib>Indolfi, Ciro</creatorcontrib><title>Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome</title><title>Circulation. Cardiovascular interventions</title><addtitle>Circ Cardiovasc Interv</addtitle><description>BACKGROUND—Ticagrelor outperforms clopidogrel in preventing cardiovascular events in acute coronary syndrome. Despite the inclusion of a loading dose in the Platelet Inhibition and Patient Outcomes (PLATO) trial for all patients randomized to ticagrelor, it may not be necessary in patients receiving ongoing clopidogrel therapy. The aim of the present study was to assess whether a ticagrelor loading dose is associated with a further platelet inhibition during the switch from clopidogrel to ticagrelor in patients with acute coronary syndrome receiving ongoing antiplatelet treatment.
METHODS AND RESULTS—Fifty patients with acute coronary syndrome receiving aspirin and clopidogrel treatment were randomly assigned to a starting dose of ticagrelor (group 1, 90 mg; group 2, 180 mg). Platelet aggregation was measured using multiple electrode aggregometry and standard light transmission aggregometry just before the switch and at 2, 6, 24, and 72 hours. No relevant difference in platelet aggregation was observed between the 2 study arms at baseline (P=0.256). Residual platelet aggregation was significantly reduced in both arms 2 hours after the first administration of ticagrelor (P<0.001 for both), with no difference in aggregation between groups (multiple electrode aggregometry, 17.6±7.2 versus 18.1±6 U; P=0.281). Similar results were observed with LTA.
CONCLUSIONS—Switching from clopidogrel to ticagrelor without a reloading dose is feasible, and it does not hinder platelet aggregation inhibition in patients with acute coronary syndrome. Further prospective studies are needed to assess the clinical relevance of our findings.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01795820.</description><subject>Acute Coronary Syndrome - drug therapy</subject><subject>Adenosine - administration & dosage</subject><subject>Adenosine - adverse effects</subject><subject>Adenosine - analogs & derivatives</subject><subject>Aged</subject><subject>Drug Dosage Calculations</subject><subject>Drug Substitution</subject><subject>Drug Synergism</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - administration & dosage</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Function Tests</subject><subject>Ticlopidine - administration & dosage</subject><subject>Ticlopidine - adverse effects</subject><subject>Ticlopidine - analogs & derivatives</subject><subject>Treatment Outcome</subject><issn>1941-7640</issn><issn>1941-7632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcGO0zAURSMEYoaBX0BvwYJNBztxmkZiQZTpMJWqFk0jWEZO_JwYnLjYDtV8Gz-HqwyzYcPK1vW591nvRtE7Sq4pXdIP5ea-3Oyq9f3X9a7a7HeHICfXhJCUxs-iS5ozusiWSfz86c7IRfTKue-EBHkZv4wuYsZYnubZZfS7EIMalfOWe2VGMBI4bA0XauzgxjiEO-5gZ6AQQnn1C2EtJbYeAvtFc48aPRRdZ7GbA24me7b6HuFwUr7t4daaAfZjZ856qc1RCRN4DZVF7gccPXgDlWr5WTUWVIgOYeHBwTfleyjaySOUxpqR2wc4PIwiZOLr6IXk2uGbx_Mqqm7XVXm32O4_b8piu2hZwuJFnMQ8LCdhgsQkXbEGszSnEokgDZNZTBu5yhLSci44a9KsaUgi27xhnEue8eQqej_HHq35OaHz9aBci1rzEc3kapqGxa6WWb4K6McZba1xzqKsj1YN4c81JfW5vfqf9oKc1HN7wf72cdLUDCiezH_rCsCnGTgZ7dG6H3o6oa175Nr3_zfjD0pysG8</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Caiazzo, Gianluca</creator><creator>De Rosa, Salvatore</creator><creator>Torella, Daniele</creator><creator>Spaccarotella, Carmen</creator><creator>Mongiardo, Annalisa</creator><creator>Giampà, Salvatore</creator><creator>Micieli, Mariella</creator><creator>Palella, Eleonora</creator><creator>Gulletta, Elio</creator><creator>Indolfi, Ciro</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201402</creationdate><title>Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome</title><author>Caiazzo, Gianluca ; De Rosa, Salvatore ; Torella, Daniele ; Spaccarotella, Carmen ; Mongiardo, Annalisa ; Giampà, Salvatore ; Micieli, Mariella ; Palella, Eleonora ; Gulletta, Elio ; Indolfi, Ciro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4342-232a05134d020584be7591fe0d0b4f721bf8730caada4b57bb03fc9b4aafa7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Coronary Syndrome - drug therapy</topic><topic>Adenosine - administration & dosage</topic><topic>Adenosine - adverse effects</topic><topic>Adenosine - analogs & derivatives</topic><topic>Aged</topic><topic>Drug Dosage Calculations</topic><topic>Drug Substitution</topic><topic>Drug Synergism</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - administration & dosage</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Platelet Function Tests</topic><topic>Ticlopidine - administration & dosage</topic><topic>Ticlopidine - adverse effects</topic><topic>Ticlopidine - analogs & derivatives</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caiazzo, Gianluca</creatorcontrib><creatorcontrib>De Rosa, Salvatore</creatorcontrib><creatorcontrib>Torella, Daniele</creatorcontrib><creatorcontrib>Spaccarotella, Carmen</creatorcontrib><creatorcontrib>Mongiardo, Annalisa</creatorcontrib><creatorcontrib>Giampà, Salvatore</creatorcontrib><creatorcontrib>Micieli, Mariella</creatorcontrib><creatorcontrib>Palella, Eleonora</creatorcontrib><creatorcontrib>Gulletta, Elio</creatorcontrib><creatorcontrib>Indolfi, Ciro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caiazzo, Gianluca</au><au>De Rosa, Salvatore</au><au>Torella, Daniele</au><au>Spaccarotella, Carmen</au><au>Mongiardo, Annalisa</au><au>Giampà, Salvatore</au><au>Micieli, Mariella</au><au>Palella, Eleonora</au><au>Gulletta, Elio</au><au>Indolfi, Ciro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome</atitle><jtitle>Circulation. Cardiovascular interventions</jtitle><addtitle>Circ Cardiovasc Interv</addtitle><date>2014-02</date><risdate>2014</risdate><volume>7</volume><issue>1</issue><spage>104</spage><epage>112</epage><pages>104-112</pages><issn>1941-7640</issn><eissn>1941-7632</eissn><abstract>BACKGROUND—Ticagrelor outperforms clopidogrel in preventing cardiovascular events in acute coronary syndrome. Despite the inclusion of a loading dose in the Platelet Inhibition and Patient Outcomes (PLATO) trial for all patients randomized to ticagrelor, it may not be necessary in patients receiving ongoing clopidogrel therapy. The aim of the present study was to assess whether a ticagrelor loading dose is associated with a further platelet inhibition during the switch from clopidogrel to ticagrelor in patients with acute coronary syndrome receiving ongoing antiplatelet treatment.
METHODS AND RESULTS—Fifty patients with acute coronary syndrome receiving aspirin and clopidogrel treatment were randomly assigned to a starting dose of ticagrelor (group 1, 90 mg; group 2, 180 mg). Platelet aggregation was measured using multiple electrode aggregometry and standard light transmission aggregometry just before the switch and at 2, 6, 24, and 72 hours. No relevant difference in platelet aggregation was observed between the 2 study arms at baseline (P=0.256). Residual platelet aggregation was significantly reduced in both arms 2 hours after the first administration of ticagrelor (P<0.001 for both), with no difference in aggregation between groups (multiple electrode aggregometry, 17.6±7.2 versus 18.1±6 U; P=0.281). Similar results were observed with LTA.
CONCLUSIONS—Switching from clopidogrel to ticagrelor without a reloading dose is feasible, and it does not hinder platelet aggregation inhibition in patients with acute coronary syndrome. Further prospective studies are needed to assess the clinical relevance of our findings.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01795820.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>24449597</pmid><doi>10.1161/CIRCINTERVENTIONS.113.000512</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-7640 |
| ispartof | Circulation. Cardiovascular interventions, 2014-02, Vol.7 (1), p.104-112 |
| issn | 1941-7640 1941-7632 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1500686798 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Acute Coronary Syndrome - drug therapy Adenosine - administration & dosage Adenosine - adverse effects Adenosine - analogs & derivatives Aged Drug Dosage Calculations Drug Substitution Drug Synergism Female Humans Male Middle Aged Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - adverse effects Platelet Function Tests Ticlopidine - administration & dosage Ticlopidine - adverse effects Ticlopidine - analogs & derivatives Treatment Outcome |
| title | Administration of a Loading Dose Has No Additive Effect on Platelet Aggregation During the Switch From Ongoing Clopidogrel Treatment to Ticagrelor in Patients With Acute Coronary Syndrome |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T01%3A50%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Administration%20of%20a%20Loading%20Dose%20Has%20No%20Additive%20Effect%20on%20Platelet%20Aggregation%20During%20the%20Switch%20From%20Ongoing%20Clopidogrel%20Treatment%20to%20Ticagrelor%20in%20Patients%20With%20Acute%20Coronary%20Syndrome&rft.jtitle=Circulation.%20Cardiovascular%20interventions&rft.au=Caiazzo,%20Gianluca&rft.date=2014-02&rft.volume=7&rft.issue=1&rft.spage=104&rft.epage=112&rft.pages=104-112&rft.issn=1941-7640&rft.eissn=1941-7632&rft_id=info:doi/10.1161/CIRCINTERVENTIONS.113.000512&rft_dat=%3Cproquest_cross%3E1500686798%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1500686798&rft_id=info:pmid/24449597&rfr_iscdi=true |