Does Ticagrelor Improve Endothelial Function?

Abstract

Ticagrelor is a P2Y12 receptor antagonist with proven clinical benefit in patients with acute coronary syndrome. Apart from its principal antiplatelet action, pleiotropic effects have been implicated in the clinical profile of ticagrelor, including a potentially beneficial impact on endothelial function. In light of the common presence and prognostic value of endothelial dysfunction in patients with coronary artery disease, several clinical studies have investigated the postulated effect of ticagrelor on endothelial function, yielding conflicting results. Limitations of the relevant studies as well as substantial differences in patient population, study design, and methods may account for these controversial findings. Most of these studies, however, support a beneficial impact of ticagrelor on endothelial function, which seems to be significant in the higher risk patients. In order to elucidate this effect, further research efforts should aim to clarify how quickly does endothelial function respond to ticagrelor, how sustained this response is during the dosing intervals and in the long term, which mechanisms are implicated, and whether this pleiotropic action is clinically significant. Future studies should include larger and diverse populations of patients, assess endothelial function at several time points after treatment initiation, and use multiple methods of endothelial function measurement, while implementing strict methodology. Nevertheless, the extent of the clinical benefit of ticagrelor attributable to actions beyond its potent and consistent antiplatelet effect remains uncertain.

• Authors: Athanasios Moulias, Ioanna Xanthopoulou, Dimitrios Alexopoulos
• Journal: Journal of cardiovascular pharmacology and therapeutics (J Cardiovasc Pharmacol Ther) Vol. 24 Issue 1 Pg. 11-17 (01 2019) ISSN: 1940-4034 [Electronic] United States
• PMID: 29991269 (Publication Type: Journal Article, Review)

Chemical References

• P2RY12 protein, human
• Platelet Aggregation Inhibitors
• Purinergic P2Y Receptor Antagonists
• Receptors, Purinergic P2Y12
• Ticagrelor

Topics

• Animals
• Coronary Artery Disease (drug therapy, metabolism, physiopathology)
• Endothelium, Vascular (drug effects, metabolism, physiopathology)
• Hemodynamics (drug effects)
• Humans
• Peripheral Arterial Disease (drug therapy, metabolism, physiopathology)
• Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
• Purinergic P2Y Receptor Antagonists (adverse effects, therapeutic use)
• Receptors, Purinergic P2Y12 (drug effects, metabolism)
• Signal Transduction
• Ticagrelor (adverse effects, therapeutic use)