Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome
(1) Background: The aim of this study was to determine clinical and genetic factors predicting the development of dyspnea in patients receiving ticagrelor. (2) Methods: A total of 277 patients with acute myocardial infarction (with and without ST-segment elevation), who underwent coronary angiograph...
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MDPI AG
2022-10-01
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| Online Access: | https://www.mdpi.com/2076-3417/12/19/10021 |
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| author | Vytenis Tamakauskas Remigijus Žaliūnas Vaiva Lesauskaitė Nora Kupstytė-Krištaponė Gintarė Šakalytė Julija Jurgaitytė Ieva Čiapienė Vacis Tatarūnas |
| author_facet | Vytenis Tamakauskas Remigijus Žaliūnas Vaiva Lesauskaitė Nora Kupstytė-Krištaponė Gintarė Šakalytė Julija Jurgaitytė Ieva Čiapienė Vacis Tatarūnas |
| author_sort | Vytenis Tamakauskas |
| collection | DOAJ |
| description | (1) Background: The aim of this study was to determine clinical and genetic factors predicting the development of dyspnea in patients receiving ticagrelor. (2) Methods: A total of 277 patients with acute myocardial infarction (with and without ST-segment elevation), who underwent coronary angiography and PTCA with stent implantation and treated with antiplatelet drugs (ticagrelor and aspirin), were enrolled in this study. Platelet aggregation (induction with high-sensitivity ADP, ADP HS) testing was performed using a MULTIPLATE analyzer and reagents for the determination of P2Y<sub>12</sub> receptor activity. Venous blood samples were collected for genotyping. (3) Results: Patients experiencing ticagrelor-related dyspnea had lower ADP HS. ROC curve analysis showed that an ADP HS cut-off of ≤19.5 U was associated with the development of dyspnea. The ADP HS value of ≤19.5 U and any dose of atorvastatin lower than 80 mg (or no atorvastatin) increased the risk of dyspnea by more than 4 and 2 times, respectively (OR = 4.07, <i>p</i> ≤ 0.001 and OR = 2.25; <i>p</i> = 0.008). (4) Conclusion: A lower ADP HS value possibly indicates greater ticagrelor activity and a higher plasma concentration of this drug. Atorvastatin might have an impact on the occurrence of ticagrelor-related dyspnea by affecting ticagrelor metabolism. No impact of any genetic variant on the development of dyspnea was determined. |
| first_indexed | 2024-03-09T22:01:00Z |
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| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-09T22:01:00Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-d2000d0bffe74c91a33209480271934d2023-11-23T19:49:37ZengMDPI AGApplied Sciences2076-34172022-10-0112191002110.3390/app121910021Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary SyndromeVytenis Tamakauskas0Remigijus Žaliūnas1Vaiva Lesauskaitė2Nora Kupstytė-Krištaponė3Gintarė Šakalytė4Julija Jurgaitytė5Ieva Čiapienė6Vacis Tatarūnas7Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, LithuaniaDepartment of Cardiology, Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Eivenių g. 2, LT-50009 Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, LithuaniaCardiovascular Centre, Republican Šiauliai Hospital, V. Kudirkos g. 99, LT-76231 Šiauliai, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, LithuaniaInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių g. 15, LT-50009 Kaunas, Lithuania(1) Background: The aim of this study was to determine clinical and genetic factors predicting the development of dyspnea in patients receiving ticagrelor. (2) Methods: A total of 277 patients with acute myocardial infarction (with and without ST-segment elevation), who underwent coronary angiography and PTCA with stent implantation and treated with antiplatelet drugs (ticagrelor and aspirin), were enrolled in this study. Platelet aggregation (induction with high-sensitivity ADP, ADP HS) testing was performed using a MULTIPLATE analyzer and reagents for the determination of P2Y<sub>12</sub> receptor activity. Venous blood samples were collected for genotyping. (3) Results: Patients experiencing ticagrelor-related dyspnea had lower ADP HS. ROC curve analysis showed that an ADP HS cut-off of ≤19.5 U was associated with the development of dyspnea. The ADP HS value of ≤19.5 U and any dose of atorvastatin lower than 80 mg (or no atorvastatin) increased the risk of dyspnea by more than 4 and 2 times, respectively (OR = 4.07, <i>p</i> ≤ 0.001 and OR = 2.25; <i>p</i> = 0.008). (4) Conclusion: A lower ADP HS value possibly indicates greater ticagrelor activity and a higher plasma concentration of this drug. Atorvastatin might have an impact on the occurrence of ticagrelor-related dyspnea by affecting ticagrelor metabolism. No impact of any genetic variant on the development of dyspnea was determined.https://www.mdpi.com/2076-3417/12/19/10021ticagrelordyspneaantiplatelet therapyticagrelor pharmacogenomicsplatelet aggregationADP HS |
| spellingShingle | Vytenis Tamakauskas Remigijus Žaliūnas Vaiva Lesauskaitė Nora Kupstytė-Krištaponė Gintarė Šakalytė Julija Jurgaitytė Ieva Čiapienė Vacis Tatarūnas Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome Applied Sciences ticagrelor dyspnea antiplatelet therapy ticagrelor pharmacogenomics platelet aggregation ADP HS |
| title | Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome |
| title_full | Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome |
| title_fullStr | Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome |
| title_full_unstemmed | Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome |
| title_short | Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome |
| title_sort | factors determining ticagrelor induced dyspnea in patients with acute coronary syndrome |
| topic | ticagrelor dyspnea antiplatelet therapy ticagrelor pharmacogenomics platelet aggregation ADP HS |
| url | https://www.mdpi.com/2076-3417/12/19/10021 |
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