What is ticagrelor, and what is its role in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Ticagrelor is a reversible inhibitor of the P2Y12 receptor that has a more rapid onset of action and a shorter half-life than clopidogrel; therefore, it is administered twice daily for maintenance. A loading dose of ticagrelor 180 mg is recommended, followed by a maintenance dose of 90 mg twice daily. 

The Platelet Inhibition and Patient Outcomes (PLATO) trial compared clopidogrel to ticagrelor in patients with NSTE-ACS and concluded that patients receiving ticagrelor had lower events of MI, stroke, and overall mortality. [100]

A unique side effect observed in patients taking ticagrelor is dyspnea, but this is rarely severe enough to cause termination of treatment. [101]

Ticagrelor should not be used concomitantly with higher doses of aspirin (>100 mg daily).

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