Article
Cardiac & Cardiovascular Systems
Marco Valgimigli, Roxana Mehran, Anna Franzone, Bruno R. da Costa, Usman Baber, Raffaele Piccolo, Eugene P. McFadden, Pascal Vranckx, Dominick J. Angiolillo, Sergio Leonardi, Davide Cao, George D. Dangas, Shamir R. Mehta, Patrick W. Serruys, C. Michael Gibson, Gabriel P. Steg, Samin K. Sharma, Christian Hamm, Richard Shlofmitz, Christoph Liebetrau, Carlo Briguori, Luc Janssens, Kurt Huber, Maurizio Ferrario, Vijay Kunadian, David J. Cohen, Aleksander Zurakowski, Keith G. Oldroyd, Han Yaling, Dariuz Dudek, Samantha Sartori, Brian Kirkham, Javier Escaned, Dik Heg, Stephan Windecker, Stuart Pocock, Peter Jueni
Summary: The study aimed to compare ticagrelor monotherapy with dual-antiplatelet therapy after PCI with drug-eluting stents. Ticagrelor monotherapy was associated with a lower risk for major bleeding compared with standard DAPT, without a concomitant increase in ischemic events.
JACC-CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Cardiac & Cardiovascular Systems
Guiomar Mendieta, Shamir Mehta, Usman Baber, Dominick J. Angiolillo, Carlo Briguori, David Cohen, Timothy Collier, George Dangas, Dariusz Dudek, Javier Escaned, Robert Gil, Birgit Vogel, Davide Cao, Alessandro Spirito, Kurt Huber, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Vijay Kunadian, David J. Moliterno, E. Magnus Ohman, Gennaro Sardella, Samantha Sartori, Samin Sharma, Richard Shlofmitz, P. Gabriel Steg, Ya-Ling Han, Stuart Pocock, C. Michael Gibson, Roxana Mehran
Summary: In high-risk patients, ticagrelor monotherapy reduces bleeding events without increasing the risk of ischemic events compared to dual antiplatelet therapy. The benefit of ticagrelor monotherapy is consistent across different bleeding and ischemic risk levels.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Javier Escaned, Davide Cao, Usman Baber, Johny Nicolas, Samantha Sartori, Zhongjie Zhang, George Dangas, Dominick J. Angiolillo, Carlo Briguori, David J. Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Vijay Kunadian, Shamir Mehta, David J. Moliterno, E. Magnus Ohman, Keith G. Oldroyd, Gennaro Sardella, Samin K. Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, Stuart Pocock, Roxana Mehran
Summary: The study evaluated the effects of ticagrelor monotherapy in HBR patients after 3 months of DAPT, showing a significant reduction in bleeding risk without increasing the risk of ischemic events. The absolute risk reduction in major bleeding was larger in HBR patients compared to non-HBR patients.
EUROPEAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Javier Escaned, Davide Cao, Usman Baber, Johny Nicolas, Samantha Sartori, Zhongjie Zhang, George Dangas, Dominick J. Angiolillo, Carlo Briguori, David J. Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Vijay Kunadian, Shamir Mehta, David J. Moliterno, E. Magnus Ohman, Keith G. Oldroyd, Gennaro Sardella, Samin K. Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, Stuart Pocock, Roxana Mehran
Summary: This study showed that ticagrelor monotherapy can significantly reduce bleeding in high bleeding risk patients without increasing ischemic events.
EUROPEAN HEART JOURNAL
(2021)
Article
Pharmacology & Pharmacy
Jawad Khalil, Tudor Dimofte, Timothy Roberts, Michael Keith, Kumuthu Amaradasa, Matthew S. Hindle, Sukhinder Bancroft, James L. Hutchinson, Khalid Naseem, Thomas Johnson, Stuart J. Mundell
Summary: This study found that the binding of ticagrelor to the P2Y(12) receptor is prolonged and more similar to that of an irreversible antagonist. This highlights the clinical need for novel ticagrelor reversal strategies in patients with bleeding.
BRITISH JOURNAL OF PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Vijay Kunadian, Usman Baber, Carlo A. Pivato, Davide Cao, George Dangas, Samantha Sartori, Zhongjie Zhang, Dominick J. Angiolillo, Carlo Briguori, David J. Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Payam Dehghani, Shamir Mehta, David J. Moliterno, E. Magnus Ohman, Javier Escaned, Gennaro Sardella, Samin K. Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, Vladimir Dzavik, Paul Gurbel, Christian W. Hamm, Timothy Henry, Adnan Kastrati, Steven O. Marx, Keith Oldroyd, P. Gabriel Steg, Stuart Pocock, Roxana Mehran
Summary: In this secondary analysis of the TWILIGHT trial, ticagrelor monotherapy was found to reduce bleeding events without increasing the risk of ischemia across different BMI categories.
JACC-CARDIOVASCULAR INTERVENTIONS
(2022)
Article
Pharmacology & Pharmacy
Kyeong Ho Yun, Jae Young Cho, Seung Yul Lee, Sang Jae Rhee, Byeong Keuk Kim, Myeong Ki Hong, Yangsoo Jang, Seok Kyu Oh
Summary: Based on the analysis of TICO trial data, it is indicated that diabetic patients who choose ticagrelor monotherapy after 3-months DAPT can reduce bleeding and decrease ischemic events like myocardial infarction, without significant differences compared with ticagrelor-based 12-months DAPT within the 12-month follow-up period.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Jeffrey J. Rade, Bruce A. Barton, Ramachandran S. Vasan, Shari S. Kronsberg, Vanessa Xanthakis, John F. Keaney, Naomi M. Hamburg, Nikolaos Kakouros, Thomas A. Kickler
Summary: This study found that systemic thromboxane generation is significantly associated with all-cause and cardiovascular mortality regardless of aspirin use. In participants without cardiovascular disease, TXB2-M is associated with cardiovascular mortality, while aspirin use is associated with all-cause mortality in those with low TXB2-M levels.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Jeffrey Triska, Neil Maitra, Matthew R. Deshotels, Faris Haddadin, Dominick J. Angiolillo, Gemma Vilahur, Hani Jneid, Dan Atar, Yochai Birnbaum
Summary: This review summarizes the pleiotropic effects of ticagrelor, including attenuation of ischemia-reperfusion injury, inflammation, adverse cardiac remodeling, and atherosclerosis. Ticagrelor exerts these effects by increasing local interstitial adenosine levels and activating downstream cardio-protective molecules. High-dose aspirin and caffeine, as well as statins, may mediate the attenuation and augmentation of these effects.
CARDIOVASCULAR DRUGS AND THERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Himawan Fernando, Thy Duong, Kevin Huynh, Jonathan Noonan, James Shaw, Stephen J. Duffy, Ziad Nehme, Karen Smith, Paul S. Myles, Peter J. Meikle, Karlheinz Peter, Dion Stub
Summary: This study evaluated the impact of intravenous fentanyl and lignocaine on the pharmacokinetics and pharmacodynamics of ticagrelor in patients with unstable angina and non-ST-elevation myocardial infarction. The results showed that lignocaine does not impair the bioavailability or delay the antiplatelet effect of ticagrelor, and both drugs were well tolerated with a high level of patient satisfaction.
EUROPEAN HEART JOURNAL
(2021)
Article
Pharmacology & Pharmacy
Ilaria D'Agostino, Stefania Tacconelli, Annalisa Bruno, Annalisa Contursi, Luciana Mucci, Xiaoyue Hu, Yi Xie, Raja Chakraborty, Kanika Jain, Angela Sacco, Mirco Zucchelli, Raffaele Landolfi, Melania Dovizio, Lorenza Falcone, Patrizia Ballerini, John Hwa, Paola Patrignani
Summary: Enhanced platelet activation, systemic TXA(2) biosynthesis, and TP gene expression were found in patients with essential hypertension and a salt-sensitive hypertension mouse model, highlighting the role of the unconstrained TXA(2)/TP pathway in their pathophysiology. Low-dose Aspirin selectively inhibiting platelet TXA(2) production was effective in reducing blood pressure and preventing early cardiac fibrosis in these hypertensive conditions.
PHARMACOLOGICAL RESEARCH
(2021)
Article
Chemistry, Medicinal
Belal O. Al-Najjar, Fadi G. Saqallah, Manal A. Abbas, Serena Z. Al-Hijazeen, Obada A. Sibai
Summary: P2Y(12) is a crucial platelet surface protein involved in platelet aggregation and thrombus formation, making it an excellent target for developing antiplatelet agents. Despite the limited number of approved medications in clinical use, there are ongoing efforts to develop new P2Y(12) inhibitors. Research also includes in-silico attempts to design novel P2Y(12) antagonists.
EUROPEAN JOURNAL OF MEDICINAL CHEMISTRY
(2022)
Review
Cell Biology
Aleksandra Gasecka, Jakub M. M. Zimodro, Yolande Appelman
Summary: Antiplatelet therapy is important for preventing cardiovascular diseases, but current guidelines are mainly based on male data and lack consistent data on the effect in women. Sex differences were reported in platelet reactivity, patient management, and clinical outcomes after treatment with antiplatelet drugs. This review aims to evaluate the need for sex-specific antiplatelet therapy and discuss the impact of sex differences on platelet biology, clinical challenges, and improvement of cardiological care for women. The article also highlights the challenges in clinical practice and the need for further investigation.
Article
Pharmacology & Pharmacy
Angela Sciacqua, Francesco Andreozzi, Elena Succurro, Daniele Pastori, Vittoria Cammisotto, Giuseppe Armentaro, Gaia C. Mannino, Teresa Vanessa Fiorentino, Pasquale Pignatelli, Dominick J. Angiolillo, Giorgio Sesti, Francesco Violi
Summary: The study found that albumin levels have an impact on the efficacy of aspirin in patients with type 2 diabetes mellitus. Patients with hypoalbuminemia are at increased risk of long-term cardiovascular events due to impaired thromboxane inhibition.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Plant Sciences
Bowen Yin, Shuhua Zhang, Yuxi Huang, Yuanzhu Long, Yiguo Chen, Shiyun Zhao, Aiqun Zhou, Minghua Cao, Xiaoming Yin, Daya Luo
Summary: This study demonstrates that Dehydroandrographolide succinate (DAS) has an antithrombotic effect and positively affects platelet aggregation, coagulation function, and coagulation factor activity.
PHARMACEUTICAL BIOLOGY
(2022)
Article
Hematology
Tobias Geisler, Sven Poli, Kurt Huber, Dominik Rath, Parwez Aidery, Steen D. Kristensen, Robert F. Storey, Alex Ball, Jean-Philippe Collet, Jurrien ten Berg
Summary: This article discusses major bleeding as a common complication in patients undergoing antiplatelet therapy and the challenges in resuming the therapy. Understanding the patient's bleeding risk and weighing it against the thrombotic risk is crucial in preventing adverse events. The article focuses on the most life-threatening bleeding events, such as intracranial hemorrhage and gastrointestinal bleeding, and discusses the evidence for resumption of antiplatelet therapy based on individual risk assessment in high-risk cardiovascular disease patients.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Hematology
Sem A. O. F. Rikken, Robert F. Storey, Felicita Andreotti, Peter Clemmensen, Jurrien M. ten Berg
Summary: Oral inhibitors of the platelet P2Y(12) receptor play a crucial role in treating STEMI, but they have limitations in terms of delayed absorption and insufficient platelet inhibition during primary percutaneous coronary intervention. There is a clinical need for drugs that can provide rapid, effective, and safe platelet inhibition in the setting of STEMI. Novel parenteral antiplatelet drugs, such as cangrelor, selatogrel, and zalunfiban, have been developed to achieve rapid and potent antiplatelet effects while preserving hemostasis, offering a potential innovation in treatment options.
THROMBOSIS AND HAEMOSTASIS
(2023)
Review
Cell Biology
Frances L. L. Varian, William A. E. Parker, James Fotheringham, Robert F. F. Storey
Summary: Chronic kidney disease is a global health problem and is associated with cardiovascular morbidity and mortality. However, the effectiveness and safety of antiplatelet therapy in patients with end-stage kidney disease are still uncertain. Therefore, more research is needed to understand the treatment options in this population.
Article
Cardiac & Cardiovascular Systems
Marcus Hjort, Kai M. Eggers, Tatevik Ghukasyan Lakic, Johan Lindback, Andrzej Budaj, Jan H. Cornel, Evangelos Giannitsis, Hugo A. Katus, Agneta Siegbahn, Robert F. Storey, Richard C. Becker, Lars Wallentin, Bertil Lindahl
Summary: Investigating biomarker concentrations and their changes can provide new insights into the pathobiology of nonobstructive myocardial infarction (MINOCA). Patients with MINOCA have higher initial inflammatory activity, similar myocardial dysfunction, and faster recovery compared to those with MI with obstructive coronary artery disease.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Cardiac & Cardiovascular Systems
Pia Davidsson, Susanna Eketjall, Niclas Eriksson, Anna Walentinsson, Richard C. Becker, Anders Cavallin, Anna Bogstedt, Anna Collen, Claes Held, Stefan James, Agneta Siegbahn, Ralph Stewart, Robert S. Storey, Harvey White, Lars Wallentin
Summary: This study investigated the associations between circulating VEGF ligands and/or soluble receptors and cardiovascular (CV) outcomes in patients with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The results showed that VEGF-D, KDR, Flt-1, and PlGF were significantly associated with CV outcomes. Furthermore, genetic variants of VEGFD were also found to be independently associated with CV outcomes.
CARDIOVASCULAR RESEARCH
(2023)
Article
Pharmacology & Pharmacy
William A. E. Parker, Dominick J. Angiolillo, Fabiana Rollini, Francesco Franchi, Marc P. Bonaca, Deepak L. Bhatt, Ph. Gabriel Steg, Rachel C. Orme, Mark R. Thomas, Heather M. Judge, Marc S. Sabatine, Robert F. Storey
Summary: This study investigated the influence of body mass on the response to ticagrelor treatment in patients with chronic coronary syndromes. The results showed that body weight was positively correlated with P2Y12 reactivity units before drug administration, but not after. The dosage of 60 mg ticagrelor was significantly correlated with body mass index. However, body mass did not affect the chance of high platelet reactivity. Overall, the currently-used regimens are adequate across different body weights and body mass index in this patient population.
VASCULAR PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Marco Valgimigli, Victor Aboyans, Dominick Angiolillo, Dan Atar, Davide Capodanno, Sigrun Halvorsen, Stefan James, Peter Juni, Vijay Kunadian, Antonio Landi, Sergio Leonardi, Roxana Mehran, Gilles Montalescot, Eliano Pio Navarese, Josef Niebauer, Angelo Oliva, Raffaele Piccolo, Susanna Price, Robert F. Storey, Heinz Voeller, Pascal Vranckx, Stephan Windecker, Keith A. A. Fox
Summary: Multiple guidelines and consensus papers have been used to address the role of antithrombotic strategies in patients with established coronary artery disease (CAD). To update clinicians on the best antithrombotic strategies for these patients, the authors conducted a consensus initiative. They systematically reviewed and performed meta-analyses using both direct and indirect comparisons to inform their recommendations.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)
Article
Cardiac & Cardiovascular Systems
Eliano Pio Navarese, Antonio Landi, Angelo Oliva, Raffaele Piccolo, Victor Aboyans, Dominick Angiolillo, Dan Atar, Davide Capodanno, Keith A. A. Fox, Sigrun Halvorsen, Stefan James, Peter Juni, Vijay Kunadian, Sergio Leonardi, Roxana Mehran, Gilles Montalescot, Josef Niebauer, Susanna Price, Robert F. Storey, Heinz Voller, Pascal Vranckx, Stephan Windecker, Marco Valgimigli
Summary: Two network meta-analyses were conducted to evaluate all available antithrombotic treatments within or after 12 months following coronary revascularization and/or acute coronary syndrome. Ticagrelor monotherapy showed lower cardiovascular mortality risk within 12 months, and P2Y(12) monotherapy, especially ticagrelor, was associated with lower risk of myocardial infarction beyond 12 months. Aspirin and rivaroxaban 2.5 mg were most effective in reducing stroke risk, with a more acceptable bleeding risk than VKA.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)
Article
Cardiac & Cardiovascular Systems
Stefan James, David Erlinge, Robert F. Storey, Darren K. Mcguire, Mark de Belder, Ida Bjoerkgren, Peter A. Johansson, Anna Maria Langkilde, Wilhelm Ridderstrale, Ehsan Parvaresh Rizi, John Deanfield, Jonas Oldgren
Summary: The DAPA-MI trial aims to study therapies that could prevent heart failure and other cardiovascular events in patients with recent myocardial infarction. The trial design includes a multicenter, randomized, double-blind, placebo-controlled approach, and utilizes national clinical registries for data collection. The results will help improve outcomes for patients after myocardial infarction.
AMERICAN HEART JOURNAL
(2023)
Review
Pharmacology & Pharmacy
William A. E. Parker, Robert F. Storey
Summary: Inflammation is a complex pathophysiological process where platelets play a crucial role in the thrombo-inflammatory response through activation and aggregation mediated by the P2Y(12) receptors. Studies using receptor antagonists like thienopyridines have shown the significant involvement of P2Y(12) receptors in inflammation, suggesting potential therapeutic strategies for a variety of inflammatory conditions.
BRITISH JOURNAL OF PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Zardasht Oqab, Vijay Kunadian, David A. Wood, Robert F. Storey, Sunil V. Rao, Roxana Mehran, Natalia Pinilla-Echeverri, Thenmozhi Mani, Robert H. Boone, Saleem Kassam, Matthias Bossard, Samer Mansour, Warren Ball, Matthew Sibbald, Nicholas Valettas, Raul Moreno, Philippe Gabriel Steg, John A. Cairns, Shamir R. Mehta
Summary: In the COMPLETE trial, the strategy of complete revascularization reduced the risk of major cardiovascular events in both diabetic and non-diabetic STEMI patients, with consistent results.
CIRCULATION-CARDIOVASCULAR INTERVENTIONS
(2023)
Article
Cardiac & Cardiovascular Systems
Bruna Gigante, Jerrold H. Levy, Eric van Gorp, Alessandro Bartoloni, Marie-Luce Bochaton-Piallat, Magnus Back, Hugo ten Cate, Christina Christersson, Jose Luis Ferreiro, Tobias Geisler, Esther Lutgens, Sam Schulman, Robert F. Storey, Jecko Thachil, Gemma Vilahur, Patricia C. Liaw, Bianca Rocca
Summary: Patients with severe infections and a pre-existing indication for antithrombotic therapy require integrated clinical counselling among coagulation, infectious disease, and cardiology specialists, due to sepsis-induced coagulopathy that frequently occurs. The association between bacterial and viral pathogens and patients with ongoing antithrombotic treatment is a growing threat to public health. This clinical consensus statement provides expert opinion and statements on the management of patients hospitalized for severe bacterial or viral infections with a pre-existing indication for antithrombotic therapy, in whom sepsis-induced coagulopathy is often observed.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Robert A. Byrne, Xavier Rossello, J. J. Coughlan, Emanuele Barbato, Colin Berry, Alaide Chieffo, Marc J. Claeys, Gheorghe-Andrei Dan, Marc R. Dweck, Mary Galbraith, Martine Gilard, Lynne Hinterbuchner, Ewa A. Jankowska, Peter Juni, Takeshi Kimura, Vijay Kunadian, Margret Leosdottir, Roberto Lorusso, Roberto F. E. Pedretti, Angelos G. Rigopoulos, Maria Rubini Gimenez, Holger Thiele, Pascal Vranckx, Sven Wassmann, Nanette Kass Wenger, Borja Ibanez, ESC Sci Document Grp
EUROPEAN HEART JOURNAL
(2023)
Article
Medicine, General & Internal
Wout W. A. Van den Broek, Marieke E. Gimbel, Dean R. P. P. Chan Pin Yin, Jaouad Azzahhafi, Renicus S. Hermanides, Craig Runnett, Robert F. Storey, David Austin, Rohit Oemrawsingh, Justin Cooke, Gavin Galasko, Ronald J. Walhout, Dirk A. A. M. Schellings, Stijn L. Brinckman, Hong Kie The, Martin G. Stoel, Antonius A. C. M. Heestermans, Debby Nicastia, Mireille E. Emans, Arnoud W. J. Van 't Hof, Hannes Alber, Robert Gerber, Paul F. M. M. Van Bergen, Ismail Aksoy, Abdul Nasser, Paul Knaapen, Cees-Joost Botman, Anho Liem, Johannes C. Kelder, Jurrien M. ten Berg
Summary: This study assessed the impact of conservative and invasive strategies on major adverse clinical events in elderly patients with NSTEMI. It found that an early invasive strategy was associated with benefits over conservative management. Risk factors associated with ischemia and bleeding should guide strategy selection rather than solely relying on age.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
M. P. Bonaca, E. Lesen, E. Giannitsis, J. Hedberg, T. Jernberg, D. Lambrelli, M. Duong, A. P. Maggioni, A. Ariza-Sole, J. ten Berg, R. F. Storey
Summary: This study provides insights into the real-world utilization of ticagrelor 60 mg in patients with prior myocardial infarction (MI) and its associated bleeding and ischemic outcomes. The observed event rates align with those in pivotal trials, reaffirming the safety profile of ticagrelor and highlighting the significant residual ischemic risk in this population.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)