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Comparison of Platelet Reactivity in Black Versus White Patients With Acute Coronary Syndromes After Treatment With Ticagrelor
Medstar Heart & Vasc Inst, Div Cardiol, Washington, DC 20007 USA..
Medstar Heart & Vasc Inst, Div Cardiol, Washington, DC 20007 USA..
Ctr Hosp Univ Toulouse, Div Cardiol, Toulouse, France..
Medstar Heart & Vasc Inst, Div Cardiol, Washington, DC 20007 USA..
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2017 (English)In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 119, no 8, 1135-1140 p.Article in journal (Refereed) Published
Abstract [en]

Ticagrelor, a potent platelet inhibitor, has primarily been studied in white patients. Platelet reactivity among black patients with acute coronary syndrome (ACS) on ticagrelor, however, is unknown. Our objective was to compare platelet reactivity in black versus white patients with ACS treated with ticagrelor. We conducted a prospective, pharmacodynamic study of 29 black patients with ACS treated with ticagrelor. Platelet reactivity was assessed at 1, 4, and 8 hours after a loading dose of ticagrelor 180 mg and at 30 days on a maintenance dose of ticagrelor 90 mg twice daily. Assays included light transmission aggregometry, VerifyNow P2Y12, and vasodilator-stimulated phosphoprotein. We provided comparison with a historical white cohort. Platelet reactivity among blacks with ACS on ticagrelor was similar to that in whites, except that blacks had lower values at 4 hours, 8 hours, and on maintenance therapy for light transmission aggregometry with 20 mu mol/L adenosine diphosphate. Among blacks, high-on-treatment platelet reactivity for all 3 assays was uncommon at 1 hour and nonexistent at 4 hours, 8 hours, and while on maintenance therapy. Blacks preloaded with clopidogrel (n = 17) had significantly lower results of VerifyNow (64 +/- 65 vs 198 +/- 86, p<0.001) and vasodilator-stimulated phosphoprotein (12.8 +/- 21.6 vs 58.9 +/- 19.9, p<0.001) at 1 hour compared with those with no clopidogrel prelOad. In conclusion, among patients with ACS receiving ticagrelor, levels of platelet reactivity in blacks are similar to that in whites. This suggests that the cardiovascular benefits of ticagrelor observed in the platelet inhibition and patient outcomes (PLATO) trial are likely to be observed in blacks and whites.

Place, publisher, year, edition, pages
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC , 2017. Vol. 119, no 8, 1135-1140 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-322180DOI: 10.1016/j.amjcard.2017.01.002ISI: 000399515000002OAI: oai:DiVA.org:uu-322180DiVA: diva2:1096109
Funder
AstraZenecaGlaxoSmithKline (GSK)
Available from: 2017-05-17 Created: 2017-05-17 Last updated: 2017-05-17Bibliographically approved

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Wallentin, Lars

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