The Effect of Low-Dose Ticagrelor on Platelet Function Profiles in Patients With Stable Coronary Artery Disease in Trini
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ORIGINAL RESEARCH
The Effect of Low-Dose Ticagrelor on Platelet Function Profiles in Patients With Stable Coronary Artery Disease in Trinidad: The TWIST Pilot Study Naveen Seecheran
. Brent Boodhai . Aarti Maharaj .
Arvinash Ramdeen . Niranjan Debideen . Vishesh Ochalal . Randall Singh . Rajeev Seecheran . Valmiki Seecheran . Sangeeta Persad . Harun Abdullah . Lakshmipathi Peram . Shastri Motilal . Antonio Tello-Montoliu . David Schneider Received: June 17, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: This prospective, pharmacodynamic study aimed to explore the potential applicability of a low-dose ticagrelor regimen in a heterogeneous Trinidadian subpopulation. Methods: Patients with stable coronary artery disease (n = 25) who were actively treated with dual antiplatelet therapy of aspirin 81 mg daily and clopidogrel 75 mg daily were recruited. Platelet function was measured with the VerifyNow P2Y12 assay (Accriva Diagnostics, San
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12706505. N. Seecheran (&) The University of the West Indies, St. Augustine, Port of Spain, Trinidad and Tobago e-mail: [email protected]; [email protected] B. Boodhai A. Maharaj A. Ramdeen N. Debideen V. Ochalal R. Singh R. Seecheran V. Seecheran S. Persad H. Abdullah L. Peram S. Motilal North Central Regional Health Authority, Champs Fleurs, Mount Hope, Trinidad and Tobago A. Tello-Montoliu Universidad de Murcia, Murcia, Spain D. Schneider Cardiovascular Research Institute of Vermont, Colchester, Vermont, USA
Diego, CA, USA) and assessed before initiation of and after 14 days of treatment with a lowdose ticagrelor 45 mg twice daily maintenance dose regimen. Results were compared with a paired t test. Results: The mean P2Y12 reaction units (PRU) score on ticagrelor was significantly less compared to that of clopidogrel (50.4, 95% confidence interval (CI) 29–73.9; vs. 149.6, 95% CI 129.4–169.9; p value \ 0.001). Of the patients, 4% experienced Medical Research Council class 1 dyspnea, and Bleeding Academic Research Consortium class 1 bleeding on the ticagrelor regimen (one patient each). Conclusions: Significantly attenuated platelet reactivity was seen on the low ticagrelor maintenance dose as compared to clopidogrel. This dedicated pharmacodynamic study could be applicable and informative for Trinidadian stable coronary artery disease patients. Further studies are required to confirm these exploratory findings.(Funded by the University of the West Indies, St. Augustine). Trial Registration: ClinicalTrials.gov number NCT04206176. Keywords: Clopidogrel; High on-treatment platelet reactivity; Ticagrelor; VerifyNow
Cardiol Ther
Key Summary Points Why carry out this study? Clopidogrel has been a mainstay of dual antiplatelet therapy (DAPT) for well over 20 years, whereas ticagrelor has recently emerged as a potent P2Y12 antiplatelet agent for the better part of the last decade. Low-dose ticagrelor can be considered a potential therapeutic opti
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