Abstract
Context: Oral reversible platelet P2Y12 receptor inhibitors (ticagrelor and elinogrel) cause double-digit rates of dyspnea, while irreversible oral antiplatelet drugs (aspirin, ticlopidoine, clopidogrel, and prasugrel) or intravenous glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban) do not increase the incidence of dyspnea in randomized trials. Dyspnea after oral reversible antiplatelet agents remains unexplained. A transfusion-related acute lung injury (TRALI) hypothesis has been proposed. The dyspnea risks after cangrelor, an intravenous reversible antiplatelet agent, are not well defined but may offer a universal mechanism linking TRALI, dyspnea, and reversible platelet inhibition. Objective: We analyzed safety data from recent head-to-head randomized trials with reversible antiplatelet agents (ticagrelor, elinogrel, and cangrelor) compared to irreversible (clopidogrel/placebo) comparators. Results: All three reversible antiplatelet agents cause excess dyspnea. In contrast to the high double-digit rates after oral ticagrelor or elinogrel, the dyspnea risks after intravenous cangrelor were smaller (
| Original language | English (US) |
|---|---|
| Pages (from-to) | 20-24 |
| Number of pages | 5 |
| Journal | Cardiology |
| Volume | 127 |
| Issue number | 1 |
| DOIs | |
| State | Published - Dec 2013 |
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Keywords
- Cangrelor
- Clinical trials
- Dyspnea
- Elinogrel
- Ticagrelor
- Transfusion-related acute lung injury
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pharmacology (medical)
Cite this
Dyspnea and reversibility of antiplatelet agents : Ticagrelor, elinogrel, cangrelor, and beyond. / Serebruany, Victor L.; Sibbing, Dirk; Dinicolantonio, James J.
In: Cardiology, Vol. 127, No. 1, 12.2013, p. 20-24.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Dyspnea and reversibility of antiplatelet agents
T2 - Ticagrelor, elinogrel, cangrelor, and beyond
AU - Serebruany, Victor L.
AU - Sibbing, Dirk
AU - Dinicolantonio, James J.
PY - 2013/12
Y1 - 2013/12
N2 - Context: Oral reversible platelet P2Y12 receptor inhibitors (ticagrelor and elinogrel) cause double-digit rates of dyspnea, while irreversible oral antiplatelet drugs (aspirin, ticlopidoine, clopidogrel, and prasugrel) or intravenous glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban) do not increase the incidence of dyspnea in randomized trials. Dyspnea after oral reversible antiplatelet agents remains unexplained. A transfusion-related acute lung injury (TRALI) hypothesis has been proposed. The dyspnea risks after cangrelor, an intravenous reversible antiplatelet agent, are not well defined but may offer a universal mechanism linking TRALI, dyspnea, and reversible platelet inhibition. Objective: We analyzed safety data from recent head-to-head randomized trials with reversible antiplatelet agents (ticagrelor, elinogrel, and cangrelor) compared to irreversible (clopidogrel/placebo) comparators. Results: All three reversible antiplatelet agents cause excess dyspnea. In contrast to the high double-digit rates after oral ticagrelor or elinogrel, the dyspnea risks after intravenous cangrelor were smaller (
AB - Context: Oral reversible platelet P2Y12 receptor inhibitors (ticagrelor and elinogrel) cause double-digit rates of dyspnea, while irreversible oral antiplatelet drugs (aspirin, ticlopidoine, clopidogrel, and prasugrel) or intravenous glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban) do not increase the incidence of dyspnea in randomized trials. Dyspnea after oral reversible antiplatelet agents remains unexplained. A transfusion-related acute lung injury (TRALI) hypothesis has been proposed. The dyspnea risks after cangrelor, an intravenous reversible antiplatelet agent, are not well defined but may offer a universal mechanism linking TRALI, dyspnea, and reversible platelet inhibition. Objective: We analyzed safety data from recent head-to-head randomized trials with reversible antiplatelet agents (ticagrelor, elinogrel, and cangrelor) compared to irreversible (clopidogrel/placebo) comparators. Results: All three reversible antiplatelet agents cause excess dyspnea. In contrast to the high double-digit rates after oral ticagrelor or elinogrel, the dyspnea risks after intravenous cangrelor were smaller (
KW - Cangrelor
KW - Clinical trials
KW - Dyspnea
KW - Elinogrel
KW - Ticagrelor
KW - Transfusion-related acute lung injury
UR - http://www.scopus.com/inward/record.url?scp=84886734513&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886734513&partnerID=8YFLogxK
U2 - 10.1159/000354876
DO - 10.1159/000354876
M3 - Article
C2 - 24192670
AN - SCOPUS:84886734513
VL - 127
SP - 20
EP - 24
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 1
ER -