Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study)
Increasing clinical trials demonstrated that the discontinuation of aspirin while maintaining a P2Y12 inhibitor monotherapy could decrease the risk of bleeding without losing the antithrombotic effect. However, no data are available on the platelet reactivity of patients undergoing ticagrelor monoth...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-11-01
|
| Series: | Platelets |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09537104.2022.2052036 |
| _version_ | 1797684103991001088 |
|---|---|
| author | Meijiao He Wei Yan Yun Zhang Yihui Kong Xuejie Han Jie Ren Zhongyang Zhao Guangzhong Liu Jing Shi Yue Li |
| author_facet | Meijiao He Wei Yan Yun Zhang Yihui Kong Xuejie Han Jie Ren Zhongyang Zhao Guangzhong Liu Jing Shi Yue Li |
| author_sort | Meijiao He |
| collection | DOAJ |
| description | Increasing clinical trials demonstrated that the discontinuation of aspirin while maintaining a P2Y12 inhibitor monotherapy could decrease the risk of bleeding without losing the antithrombotic effect. However, no data are available on the platelet reactivity of patients undergoing ticagrelor monotherapy vs. clopidogrel. Therefore, we performed this study to observe the efficacy of ticagrelor monotherapy vs. clopidogrel in Chinese patients with chronic coronary syndrome. This randomized, single-blinded, crossover trial enrolled 50 patients who were administered with ticagrelor (90 mg twice daily for 2 weeks) or clopidogrel (75 mg once daily for 2 weeks). Followed by a 2-week washout period, the two groups of patients underwent a crossover trial. Light transmission aggregometry (LTA) and thromboelastography (TEG) assays were used to test platelet reactivity. The platelet aggregation rate (PAgR) of ADP and AA was significantly lower with ticagrelor than clopidogrel (PAgR of ADP, 27.30% (7.30%-42.635%) vs. 35.55% (12.03%-69.25%), P = .0254; PAgR of AA, 77.80% (21.60%-86.43%) vs. 83.10% (67.13%-87.20%), P = .0400). There was no significant difference in PAgR of collagen and epinephrine between the two groups. The TEG assay showed that ADP and AA, which induced the inhibition of platelet aggregation, were significantly higher in the ticagrelor group than those in the clopidogrel group [ADP%, 69.00% (59.68%–88.95%) vs. 60.55% (35.98%–78.35%), P = .0020; AA%, 53.65% (22.75%–79.28%) vs. 15.15% (5.75%–70.25%), P = .0127]. High on-treatment platelet reactivity (HTPR) on ADP was 2.17% with ticagrelor and 19.57% with clopidogrel. HTPR on AA was 50.00% with ticagrelor and 69.57% with clopidogrel. Ticagrelor and clopidogrel caused the inhibition of ADP and AA-induced platelet aggregation. Moreover, ticagrelor monotherapy had a stronger inhibitory effect than clopidogrel monotherapy (except on collagen and epinephrine). |
| first_indexed | 2024-03-12T00:25:41Z |
| format | Article |
| id | doaj.art-ed5094c7d3d94b6c990d2486a135dd6a |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:25:41Z |
| publishDate | 2022-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-ed5094c7d3d94b6c990d2486a135dd6a2023-09-15T10:38:11ZengTaylor & Francis GroupPlatelets0953-71041369-16352022-11-013381146115210.1080/09537104.2022.20520362052036Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study)Meijiao He0Wei Yan1Yun Zhang2Yihui Kong3Xuejie Han4Jie Ren5Zhongyang Zhao6Guangzhong Liu7Jing Shi8Yue Li9The First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityThe First Affiliated Hospital of Harbin Medical University, Harbin Medical UniversityIncreasing clinical trials demonstrated that the discontinuation of aspirin while maintaining a P2Y12 inhibitor monotherapy could decrease the risk of bleeding without losing the antithrombotic effect. However, no data are available on the platelet reactivity of patients undergoing ticagrelor monotherapy vs. clopidogrel. Therefore, we performed this study to observe the efficacy of ticagrelor monotherapy vs. clopidogrel in Chinese patients with chronic coronary syndrome. This randomized, single-blinded, crossover trial enrolled 50 patients who were administered with ticagrelor (90 mg twice daily for 2 weeks) or clopidogrel (75 mg once daily for 2 weeks). Followed by a 2-week washout period, the two groups of patients underwent a crossover trial. Light transmission aggregometry (LTA) and thromboelastography (TEG) assays were used to test platelet reactivity. The platelet aggregation rate (PAgR) of ADP and AA was significantly lower with ticagrelor than clopidogrel (PAgR of ADP, 27.30% (7.30%-42.635%) vs. 35.55% (12.03%-69.25%), P = .0254; PAgR of AA, 77.80% (21.60%-86.43%) vs. 83.10% (67.13%-87.20%), P = .0400). There was no significant difference in PAgR of collagen and epinephrine between the two groups. The TEG assay showed that ADP and AA, which induced the inhibition of platelet aggregation, were significantly higher in the ticagrelor group than those in the clopidogrel group [ADP%, 69.00% (59.68%–88.95%) vs. 60.55% (35.98%–78.35%), P = .0020; AA%, 53.65% (22.75%–79.28%) vs. 15.15% (5.75%–70.25%), P = .0127]. High on-treatment platelet reactivity (HTPR) on ADP was 2.17% with ticagrelor and 19.57% with clopidogrel. HTPR on AA was 50.00% with ticagrelor and 69.57% with clopidogrel. Ticagrelor and clopidogrel caused the inhibition of ADP and AA-induced platelet aggregation. Moreover, ticagrelor monotherapy had a stronger inhibitory effect than clopidogrel monotherapy (except on collagen and epinephrine).http://dx.doi.org/10.1080/09537104.2022.2052036chronic coronary syndromeclopidogrelplatelet aggregationticagrelor |
| spellingShingle | Meijiao He Wei Yan Yun Zhang Yihui Kong Xuejie Han Jie Ren Zhongyang Zhao Guangzhong Liu Jing Shi Yue Li Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) Platelets chronic coronary syndrome clopidogrel platelet aggregation ticagrelor |
| title | Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) |
| title_full | Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) |
| title_fullStr | Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) |
| title_full_unstemmed | Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) |
| title_short | Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study) |
| title_sort | effects of ticagrelor monotherapy vs clopidogrel monotherapy on platelet reactivity a randomized crossover clinical study single study |
| topic | chronic coronary syndrome clopidogrel platelet aggregation ticagrelor |
| url | http://dx.doi.org/10.1080/09537104.2022.2052036 |
| work_keys_str_mv | AT meijiaohe effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT weiyan effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT yunzhang effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT yihuikong effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT xuejiehan effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT jieren effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT zhongyangzhao effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT guangzhongliu effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT jingshi effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy AT yueli effectsofticagrelormonotherapyvsclopidogrelmonotherapyonplateletreactivityarandomizedcrossoverclinicalstudysinglestudy |