Via practica 3–4/2013

Ticagrelor – a new reversible inhibitor of P2Y12 receptor in the treatment of acute coronary syndromes

Background. Antiplatelet therapy is crucial for the successful management of acute coronary syndromes (ACS) in either conservative or interventive and surgical strategy ACS. The mechanism of interaction endothelium – platelets – and other complex bonds and mutual interactions, are already relatively well researched. So far antiplatelet therapy clopidogrel + aspirin significantly contributed to improving of the treatment of patients with ACS, but despite this treatment thrombotic events persist at an earlier or a later term. Goal. Briefly explain and summarize current knowledge about relevant new antiplatelet treatment with ticagrelor in patients with acute coronary syndrome with or without ST segment elevation in the ECG image. Conclusion. Ticagrelor is due to its mechanism of action and results in the treatment of patients with ACS breakthrough drug that belongs to a daily antiplatelet armamentarium in the management of ACS. Distinctive profile of treatment with ticagrelor + aspirin versus other antiplatelet therapy have those patients with ACS, who are age ≥ 75 years, have weight ≤ 60 kg, creatinine clearance ≤ 60 mL/min, are after TIA or ischemic stroke, have hypersensitivity to thienopyridines, including also patients already treated with clopidogrel, patients without knowledge of coronary anatomy. In patients with ACS, if ticagrelor eventually prasugrel can not be given from any reasons, is still indicated clopidogrel.

Keywords: antiplatelet therapy, acute coronary syndromes, ticagrelor.