TY - JOUR
T1 - Ticagrelor Resistance in Cardiovascular Disease and Ischemic Stroke
AU - He, Song
AU - Lin, Yapeng
AU - Tan, Quandan
AU - Mao, Fengkai
AU - Chen, Kejie
AU - Hao, Junli
AU - Le, Weidong
AU - Yang, Jie
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Ticagrelor, acting as a reversible platelet aggregation inhibitor of P2Y12 receptors (P2Y12R), is regarded as one of the first-line antiplatelet drugs for acute cardiovascular diseases. Though the probability of ticagrelor resistance is much lower than that of clopidogrel, there have been recent reports of ticagrelor resistance. In this review, we summarized the clinical application of ticagrelor and then presented the criteria and current status of ticagrelor resistance. We further discussed the potential mechanisms for ticagrelor resistance in terms of drug absorption, metabolism, and receptor action. In conclusion, the incidences of ticagrelor resistance fluctuated between 0 and 20%, and possible mechanisms mainly arose from its absorption and receptor action. Specifically, a variety of factors, such as the drug form of ticagrelor, gut microecology, and the expression and function of P-glycoprotein (P-gp) and P2Y12R, have been shown to be associated with ticagrelor resistance. The exact mechanisms of ticagrelor resistance warrant further exploration, which may contribute to the diagnosis and treatment of ticagrelor resistance.
AB - Ticagrelor, acting as a reversible platelet aggregation inhibitor of P2Y12 receptors (P2Y12R), is regarded as one of the first-line antiplatelet drugs for acute cardiovascular diseases. Though the probability of ticagrelor resistance is much lower than that of clopidogrel, there have been recent reports of ticagrelor resistance. In this review, we summarized the clinical application of ticagrelor and then presented the criteria and current status of ticagrelor resistance. We further discussed the potential mechanisms for ticagrelor resistance in terms of drug absorption, metabolism, and receptor action. In conclusion, the incidences of ticagrelor resistance fluctuated between 0 and 20%, and possible mechanisms mainly arose from its absorption and receptor action. Specifically, a variety of factors, such as the drug form of ticagrelor, gut microecology, and the expression and function of P-glycoprotein (P-gp) and P2Y12R, have been shown to be associated with ticagrelor resistance. The exact mechanisms of ticagrelor resistance warrant further exploration, which may contribute to the diagnosis and treatment of ticagrelor resistance.
KW - cardiovascular disease
KW - epigenetics
KW - genetics
KW - high on-treatment platelet reactivity
KW - ischemic stroke
KW - ticagrelor resistance
UR - http://www.scopus.com/inward/record.url?scp=85147802480&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147802480&partnerID=8YFLogxK
U2 - 10.3390/jcm12031149
DO - 10.3390/jcm12031149
M3 - Review article
C2 - 36769796
AN - SCOPUS:85147802480
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 3
M1 - 1149
ER -