Ticagrelor Resistance in Cardiovascular Disease and Ischemic Stroke.
Song HeYapeng LinQuandan TanFengkai MaoKejie ChenJunli HaoWeidong LeJie YangPublished in: Journal of clinical medicine (2023)
Ticagrelor, acting as a reversible platelet aggregation inhibitor of P2Y12 receptors (P2Y12R), is regarded as one of the first-line antiplatelet drugs for acute cardiovascular diseases. Though the probability of ticagrelor resistance is much lower than that of clopidogrel, there have been recent reports of ticagrelor resistance. In this review, we summarized the clinical application of ticagrelor and then presented the criteria and current status of ticagrelor resistance. We further discussed the potential mechanisms for ticagrelor resistance in terms of drug absorption, metabolism, and receptor action. In conclusion, the incidences of ticagrelor resistance fluctuated between 0 and 20%, and possible mechanisms mainly arose from its absorption and receptor action. Specifically, a variety of factors, such as the drug form of ticagrelor, gut microecology, and the expression and function of P-glycoprotein (P-gp) and P2Y12R, have been shown to be associated with ticagrelor resistance. The exact mechanisms of ticagrelor resistance warrant further exploration, which may contribute to the diagnosis and treatment of ticagrelor resistance.
Keyphrases
- acute coronary syndrome
- percutaneous coronary intervention
- antiplatelet therapy
- st segment elevation myocardial infarction
- st elevation myocardial infarction
- cardiovascular disease
- coronary artery disease
- atrial fibrillation
- type diabetes
- emergency department
- current status
- cardiovascular events
- electronic health record
- metabolic syndrome
- adverse drug
- acute respiratory distress syndrome
- binding protein
- mechanical ventilation
- cardiovascular risk factors
- human health