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Current controversies in the use of aspirin and ticagrelor for the treatment of thrombotic events
journal contribution
posted on 2023-06-09, 14:05 authored by Udaya S. Tantry, Jacek Kubica, Aung Myat, Paul A GurbelA P2Y12 inhibitor plus aspirin is the most widely used antiplatelet strategy to prevent adverse outcomes in the setting of atherothrombotic vascular disease. Areas covered: A paucity of robust evidence for an optimal dose, gastrointestinal toxicity, ineffectiveness in high-risk patients and interactions with other antiplatelet agents, are major controversies associated with aspirin therapy. Ticagrelor is a reversibly binding oral P2Y12 receptor blocker that mediates potent inhibition of adenosine diphosphate-induced platelet function. It is more effective than clopidogrel in preventing thrombotic events in acute coronary syndrome patients. The absence of a beneficial effect for ticagrelor versus clopidogrel in ACS observed in the North American subgroup of the PLATelet inhibition and patient Outcomes (PLATO) trial has been attributed to a higher concomitant aspirin dose. Expert commentary: Ongoing studies are now investigating the plausibility of removing aspirin therapy in the setting of potent P2Y12 receptor blockade via ticagrelor monotherapy or replacing aspirin with an oral anticoagulant.
History
Publication status
- Published
Journal
Expert Review of Cardiovascular TherapyISSN
1744-8344Publisher
Taylor & FrancisExternal DOI
Issue
12Volume
14Page range
1361-1370Department affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- No
Peer reviewed?
- Yes