Document Type : Original Article
Authors
1
Clinical Pharmacist, Coronary Care Unit, Assiut University Heart Hospital, Assiut, Egypt
2
Department of Cardiovascular Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
3
Department of Pharmaceutics, Faculty of Pharmacy, Assiut University, Assiut, Egypt
4
Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, Egypt
Abstract
Objectives: The new generation antiplatelets are generally recommended by the current US and European guidelines. This article aimed to address the efficacy and safety of using ticagrelor in patients with ST-elevated acute coronary syndromes.
Methods: This was a prospective observational study on 120 patients admitted to the Cardiology Care Unit of Assiut University Hospital with ST-segment elevation acute coronary syndrome, who were admitted for urgent revascularization and received aspirin and the P2Y12 antagonist ticagrelor. The patients were followed for three months between May 2018 and September 2019. The primary efficacy end point was the incidence of major adverse cardiovascular events (MACE).
Results: At three months, the primary efficacy end point, a composite of cardiovascular death, myocardial infarction, or stroke - occurred in 11/120 (9.2%) patients. The primary safety end point, the incidence of major bleeding, was observed in two patients (1.7%) with no fatal bleedings. Minor and minimal bleeding occurred in 2.5% and 20.8% of patients, respectively. Other efficacy endpoint was myocardial infarction 4.2% and stent thrombosis (1.7%). Severe dyspnea found in 5.0% patients and led to 1.7% ticagrelor discontinuation. Multivariate regression analysis revealed no association between bleeding and patients’ age, sex nor IV administration of glycoprotein IIb/IIIa inhibitor.
Conclusion: The MACE with ticagrelor was higher than previously reported in most studies. Dyspnea rate was higher and more pronounced than bleeding rate. The majority of bleeding cases was minimal with no fatal major bleeding and no bleeding led to comorbidity.
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