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Selatogrel and other P2Y12 inhibitors' putative off-target effects. J Cardiovasc Pharmacol 2021; 79:153-154. [PMID: 34475343 DOI: 10.1097/fjc.0000000000001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ortega-Paz L, Brugaletta S, Ariotti S, Akkerhuis KM, Karagiannis A, Windecker S, Valgimigli M. Adenosine and Ticagrelor Plasma Levels in Patients With and Without Ticagrelor-Related Dyspnea. Circulation 2019; 138:646-648. [PMID: 29794083 DOI: 10.1161/circulationaha.118.034489] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luis Ortega-Paz
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Spain (L.O-P., S.B.)
| | - Salvatore Brugaletta
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Spain (L.O-P., S.B.)
| | - Sara Ariotti
- Swiss Cardiovascular Center Bern, Bern University Hospital (S.A., S.W., M.V.)
| | | | - Alexios Karagiannis
- Clinical Trial Unit Bern, and Institute of Social and Preventive Medicine, University of Bern, Switzerland (A.K.)
| | - Stephan Windecker
- Swiss Cardiovascular Center Bern, Bern University Hospital (S.A., S.W., M.V.)
| | - Marco Valgimigli
- Swiss Cardiovascular Center Bern, Bern University Hospital (S.A., S.W., M.V.)
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Effects of Ticagrelor, Prasugrel, or Clopidogrel at Steady State on Endothelial Function. J Am Coll Cardiol 2019; 71:1289-1291. [PMID: 29544613 DOI: 10.1016/j.jacc.2018.01.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 11/24/2022]
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Reply. JACC Cardiovasc Interv 2018; 11:1785-1786. [DOI: 10.1016/j.jcin.2018.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/26/2018] [Indexed: 11/19/2022]
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Ariotti S, Ortega-Paz L, van Leeuwen M, Brugaletta S, Leonardi S, Akkerhuis KM, Rimoldi SF, Janssens G, Gianni U, van den Berge JC, Karagiannis A, Windecker S, Valgimigli M. Effects of Ticagrelor, Prasugrel, or Clopidogrel on Endothelial Function and Other Vascular Biomarkers: A Randomized Crossover Study. JACC Cardiovasc Interv 2018; 11:1576-1586. [PMID: 29805112 DOI: 10.1016/j.jcin.2018.04.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/13/2018] [Accepted: 04/13/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The study sought to assess whether treatment with ticagrelor, as compared with prasugrel and clopidogrel, improves endothelium-dependent dilation throughout the course of the treatment and other vascular biomarkers, including systemic adenosine plasma levels. BACKGROUND The in vivo off-target effects of ticagrelor in post-acute coronary syndrome (ACS) patients remain poorly characterized. METHODS Fifty-four stable post-ACS patients were sequentially exposed to each of the 3 oral P2Y12 inhibitors following a 3-period balanced Latin square crossover design with 4 weeks per treatment in 5 European centers. The primary endpoint was the assessment of endothelial function with pulse amplitude tonometry and expressed as reactive hyperemia index at treatment steady state. Secondary endpoints included reactive hyperemia index after loading or before maintenance regimen, systemic adenosine plasma levels, a wide set of vascular biomarkers, and ticagrelor or AR-C124910XX plasma levels throughout each ticagrelor period. In 9 patients, the evaluation of endothelial function was performed simultaneously by pulse amplitude tonometry and flow-mediated dilation. RESULTS Reactive hyperemia index did not differ after ticagrelor (1.970 ± 0.535) as compared with prasugrel (2.007 ± 0.640; p = 0.557) or clopidogrel (2.072 ± 0.646; p = 0.685), nor did systemic adenosine plasma levels or vascular biomarkers at any time points. P2Y12 platelet reactivity units were lower after ticagrelor as compared with clopidogrel at all time points and after maintenance dose as compared with prasugrel. Flow-mediated dilation did not differ after the maintenance dose of ticagrelor as compared with clopidogrel and prasugrel. CONCLUSIONS Ticagrelor did not improve endothelial function or increased systemic adenosine plasma levels as compared with prasugrel and clopidogrel in stabilized patients who suffered from an ACS. (Hunting for the Off-Target Properties of Ticagrelor on Endothelial Function in Humans [HI-TECH]; NCT02587260).
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Affiliation(s)
- Sara Ariotti
- Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland
| | - Luis Ortega-Paz
- Cardiovascular Clinic Institute, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Maarten van Leeuwen
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands; Department of Cardiology, Isala Heart Centre, Zwolle, the Netherlands
| | - Salvatore Brugaletta
- Cardiovascular Clinic Institute, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Sergio Leonardi
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - K Martijn Akkerhuis
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stefano F Rimoldi
- Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland
| | - Gladys Janssens
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Umberto Gianni
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jan C van den Berge
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alexios Karagiannis
- CTU Bern, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland
| | - Marco Valgimigli
- Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland.
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Xanthopoulou I, Bei I, Bampouri T, Barampoutis N, Moulias A, Davlouros P, Alexopoulos D. Absence of differential effect of ticagrelor versus prasugrel maintenance dose on endothelial function in patients with stable coronary artery disease. Hellenic J Cardiol 2017; 59:338-343. [PMID: 29292242 DOI: 10.1016/j.hjc.2017.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Endothelial function may be improved by ticagrelor through adenosine-mediated mechanisms. We aimed to assess the effect of ticagrelor versus prasugrel on endothelial function in patients with stable coronary artery disease (CAD). METHODS In a prospective, randomized, crossover study, 22 stable CAD patients under prasugrel 10 mg once daily maintenance dose (MD) for at least 3 months were randomized to either ticagrelor 90 mg twice daily or prasugrel 10 mg once daily for 15 days with a direct treatment-crossover for another 15 days. Endothelial function was assessed by peripheral arterial tonometry (EndoPAT 2000 system, Itamar Medical, Caesarea, Israel) at Day 0 (randomization), Day 15, and Day 30. Reactive Hyperemia Index (RHI) was calculated by using an automated software, and endothelial dysfunction (ED) was defined as RHI <1.67. RHI at the end of the two treatment periods did not differ between ticagrelor and prasugrel MD treatments. Least squares estimates (95% confidence interval) were 1.78 (1.58-1.99) versus 1.88 (1.67-2.08), with a fixed estimate of -0.099 (95% CI: -0.45 to 0.25) for the difference between them (p = 0.5). ED rate did not differ significantly between ticagrelor and prasugrel (45.5% vs 45.5%, p = 0.6). CONCLUSIONS In CAD patients, we have failed to find evidence of alteration of endothelial function following ticagrelor compared to prasugrel MD treatment, as assessed by peripheral arterial tonometry. CLINICALTRIALS. GOV UNIQUE IDENTIFIER NCT01957540.
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Affiliation(s)
| | - Ilianna Bei
- Department of Cardiology, Patras University Hospital, Rion, Patras, Greece
| | - Theodora Bampouri
- Department of Cardiology, Patras University Hospital, Rion, Patras, Greece
| | | | - Athanasios Moulias
- Department of Cardiology, Patras University Hospital, Rion, Patras, Greece
| | - Periklis Davlouros
- Department of Cardiology, Patras University Hospital, Rion, Patras, Greece
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Danielak D, Karaźniewicz-Łada M, Główka F. Ticagrelor in modern cardiology - an up-to-date review of most important aspects of ticagrelor pharmacotherapy. Expert Opin Pharmacother 2017; 19:103-112. [DOI: 10.1080/14656566.2017.1421634] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Dorota Danielak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland
| | - Franciszek Główka
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland
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