Pharmacodynamic Effects of Ticagrelor Dosing Regimens in XXXX on Maintenance Ticagrelor Therapy: Results From a Prospective, Randomized, Double-Blind Investigation.

@entity1 @entity2405 @entity1423 @entity117 @entity3077 @entity857 @entity3075 @entity22
OBJECTIVES: The aim of this study was to assess the impact of ticagrelor dosing regimens on pharmacodynamic (PD) profiles in @entity1 on maintenance ticagrelor therapy. BACKGROUND: Many @entity1 on maintenance @entity3075 -inhibiting therapies may require coronary revascularization procedures, raising a common clinical question with regard to the dosing regimen of the @entity3075 -inhibiting agent to be used. To date, investigations assessing dosing regimens of @entity3075 receptor inhibitors in @entity1 on maintenance therapy have been only assessed with @entity2405 , but not with ticagrelor. METHODS: This was a prospective, randomized, double-blind, placebo-controlled study assessing the PD effects of 2  dosing regimens of ticagrelor in @entity1 on standard @entity117 and ticagrelor maintenance therapy. A total of 60 @entity1 were randomized to either 90 mg ( @entity22 [ @entity22 ] group) or 180 mg (loading dose [LD] group) dose of ticagrelor. PD assessments were conducted at 3 time points (baseline, 1 h and 4 h). PD assessments were defined according to the platelet reactivity index (PRI) (vasodilator-stimulated phosphoprotein phosphorylation assay), @entity3075 reaction unit  (VerifyNow @entity3075 assay) and @entity857 -induced @entity1423 by light transmittance aggregometry. RESULTS: There were no differences in baseline levels of platelet reactivity with all assays. Intergroup comparisons by means of repeated-measures analysis adjusted for baseline PRI values showed that the LD group had significantly lower  PRI levels compared with the @entity22 group during the overall study time course (p  = 0.031). Consistent findings were  found for @entity3075 reaction unit (p  = 0.026) and light transmittance aggregometry (p  = 0.004). Intragroup comparisons showed that a more prompt and sustained platelet inhibitory effect was achieved more consistently with an LD regimen compared with a @entity22 regimen. CONCLUSIONS: In @entity1 on maintenance ticagrelor therapy, a 180-mg LD regimen of @entity3077 is associated with more potent and prompt platelet inhibition compared with a 90-mg @entity22 . (Impact of Ticagrelor Re-Load Pharmacodynamic Profiles; NCT01731041).
