Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS)
Abstract Background Dual antiplatelet therapy with aspirin and a thienopyridine is used to prevent thrombotic complications of acute coronary syndrome (ACS) and percutaneous coronary interventions (PCI). Ticagrelor is an oral, reversible inhibitor of the adenosine diphosphate receptor P2Y12 with a f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-06-01
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| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-022-00290-w |
| _version_ | 1811230764263538688 |
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| author | Hesham S. Taha Hossam Kandil Nabil Farag Amr Zaki Hossam Mahrous Mirna M. Shaker |
| author_facet | Hesham S. Taha Hossam Kandil Nabil Farag Amr Zaki Hossam Mahrous Mirna M. Shaker |
| author_sort | Hesham S. Taha |
| collection | DOAJ |
| description | Abstract Background Dual antiplatelet therapy with aspirin and a thienopyridine is used to prevent thrombotic complications of acute coronary syndrome (ACS) and percutaneous coronary interventions (PCI). Ticagrelor is an oral, reversible inhibitor of the adenosine diphosphate receptor P2Y12 with a faster onset and more potent platelet inhibition than clopidogrel. A study was needed to evaluate the efficacy and safety of generic ticagrelor in Egyptian patients. Results This multicenter study included 830 patients aged above 40 years and diagnosed with ACS, with or without ST segment elevation during the preceding 6 months. They received generic ticagrelor (Thrombolinta, Global Napi Pharmaceutical Company, Egypt) (180 mg loading dose, 90 mg twice daily thereafter), added to aspirin 75–100 mg daily. The mean age of our study population was 57.5 (8.3) years and 38.3% were females. Hypertension, diabetes mellitus, dyslipidemia and previous coronary revascularization were present in 70.7%, 59.2%, 80.7% and 31% of the patients, respectively, and 42.5% were current smokers. The qualifying event was unstable angina, non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction in 54%, 21.8% and 24.2% of the patients, respectively. At 6 months, the primary efficacy end point—a composite of cardiovascular death, myocardial infarction and stroke—occurred in 3.4% of patients, while the secondary efficacy endpoint—a composite of the primary efficacy endpoints with the addition of hospitalization for unstable angina and urgent revascularization—occurred in 15.3%. Cardiovascular death occurred in 1.2% of the patients, myocardial infarction in 0.8%, stroke in 1.3%, hospitalization for UA in 8.1% and urgent revascularization in 3.9%. TIMI major bleeding occurred in 1.2% of patients, intracranial hemorrhage in 0.2% and TIMI minor bleeding in 13.3%. No significant difference was found between patients who underwent PCI at baseline and those who were treated conservatively regarding the primary (14 patients in each group, P = 0.931) and secondary (62 vs. 65 patients, P = 0.946) efficacy endpoints. Conclusions In patients who had an ACS during the 6 months preceding enrollment, treatment with generic ticagrelor led to a low rate of cardiovascular death, myocardial infarction and stroke with a minor increase in the risk of major bleeding. |
| first_indexed | 2024-04-12T10:33:25Z |
| format | Article |
| id | doaj.art-37194dbca7d448c9a71cdda5c5da81d0 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-12T10:33:25Z |
| publishDate | 2022-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-37194dbca7d448c9a71cdda5c5da81d02022-12-22T03:36:47ZengSpringerOpenThe Egyptian Heart Journal2090-911X2022-06-017411710.1186/s43044-022-00290-wInsights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS)Hesham S. Taha0Hossam Kandil1Nabil Farag2Amr Zaki3Hossam Mahrous4Mirna M. Shaker5Department of Cardiology, Faculty of Medicine, Cairo UniversityDepartment of Cardiology, Faculty of Medicine, Cairo UniversityAin-Shams UniversityAlexandria UniversityDepartment of Cardiology, Faculty of Medicine, Cairo UniversityDepartment of Cardiology, Faculty of Medicine, Cairo UniversityAbstract Background Dual antiplatelet therapy with aspirin and a thienopyridine is used to prevent thrombotic complications of acute coronary syndrome (ACS) and percutaneous coronary interventions (PCI). Ticagrelor is an oral, reversible inhibitor of the adenosine diphosphate receptor P2Y12 with a faster onset and more potent platelet inhibition than clopidogrel. A study was needed to evaluate the efficacy and safety of generic ticagrelor in Egyptian patients. Results This multicenter study included 830 patients aged above 40 years and diagnosed with ACS, with or without ST segment elevation during the preceding 6 months. They received generic ticagrelor (Thrombolinta, Global Napi Pharmaceutical Company, Egypt) (180 mg loading dose, 90 mg twice daily thereafter), added to aspirin 75–100 mg daily. The mean age of our study population was 57.5 (8.3) years and 38.3% were females. Hypertension, diabetes mellitus, dyslipidemia and previous coronary revascularization were present in 70.7%, 59.2%, 80.7% and 31% of the patients, respectively, and 42.5% were current smokers. The qualifying event was unstable angina, non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction in 54%, 21.8% and 24.2% of the patients, respectively. At 6 months, the primary efficacy end point—a composite of cardiovascular death, myocardial infarction and stroke—occurred in 3.4% of patients, while the secondary efficacy endpoint—a composite of the primary efficacy endpoints with the addition of hospitalization for unstable angina and urgent revascularization—occurred in 15.3%. Cardiovascular death occurred in 1.2% of the patients, myocardial infarction in 0.8%, stroke in 1.3%, hospitalization for UA in 8.1% and urgent revascularization in 3.9%. TIMI major bleeding occurred in 1.2% of patients, intracranial hemorrhage in 0.2% and TIMI minor bleeding in 13.3%. No significant difference was found between patients who underwent PCI at baseline and those who were treated conservatively regarding the primary (14 patients in each group, P = 0.931) and secondary (62 vs. 65 patients, P = 0.946) efficacy endpoints. Conclusions In patients who had an ACS during the 6 months preceding enrollment, treatment with generic ticagrelor led to a low rate of cardiovascular death, myocardial infarction and stroke with a minor increase in the risk of major bleeding.https://doi.org/10.1186/s43044-022-00290-wAntiplatelet therapyAcute coronary syndromeCardiovascular deathBleeding |
| spellingShingle | Hesham S. Taha Hossam Kandil Nabil Farag Amr Zaki Hossam Mahrous Mirna M. Shaker Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) The Egyptian Heart Journal Antiplatelet therapy Acute coronary syndrome Cardiovascular death Bleeding |
| title | Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) |
| title_full | Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) |
| title_fullStr | Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) |
| title_full_unstemmed | Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) |
| title_short | Insights from Egyptian ticagrelor study in patients who presented with acute coronary syndrome (ETS in ACS) |
| title_sort | insights from egyptian ticagrelor study in patients who presented with acute coronary syndrome ets in acs |
| topic | Antiplatelet therapy Acute coronary syndrome Cardiovascular death Bleeding |
| url | https://doi.org/10.1186/s43044-022-00290-w |
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