Reversal of the antiplatelet effect of ticagrelor by simulated platelet transfusion
| Autor: | John W. Eikelboom, Shu-Hua Zhang, Fengwei Zou, Lianlian Mei, Ke Xu, Chunjian Li, Jimin Li, Jing Zhang, Fei Wang, Hui Zhu, Kelecia Niles, Lu Yang, Yuansheng Fan |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Ticagrelor Platelet Aggregation Immunology Platelet Transfusion 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial law medicine Immunology and Allergy Ingestion Humans Platelet Aged Aged 80 and over Aspirin business.industry Hematology Middle Aged Healthy Volunteers Clopidogrel Adenosine Diphosphate Platelet transfusion Anesthesia Cohort Female business 030215 immunology medicine.drug Blood sampling |
| Zdroj: | Transfusion. 59(5) |
| ISSN: | 1537-2995 |
| Popis: | Background Reversal of antiplatelet therapy is desirable in patients presenting with life-threatening bleeding or requiring urgent surgery. This study aimed to examine ticagrelor reversal using donor platelets and to explore the effects of residual ticagrelor on donor platelets. Study design and methods In Cohort 1, 16 healthy subjects were treated with ticagrelor 90 mg twice daily alone or in combination with aspirin 100 mg once daily for 7 days followed by single blood sampling for preparation of platelet-rich plasma. An additional 16 healthy subjects served as controls. In Cohort 2, 16 healthy subjects were treated with ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily for 7 days followed by serial blood samplings for preparation of platelet-poor plasma (PPP). An additional 16 healthy subjects served as controls. Results In Cohort 1, inhibition of adenosine diphosphate-induced platelet aggregation (PLADP ) by ticagrelor could not be fully reversed by mixing with up to 90% control platelets, whereas inhibition of arachidonic acid-induced platelet aggregation by aspirin was fully reversed with the addition of 60% control platelets. In Cohort 2, 10% PPP obtained from ticagrelor-treated subjects reduced PLADP from 74% to 40% at 2 hours, 72% to 58% at 6 hours, and 73% to 59% at 10 hours, while 10% or 20% PPP obtained from clopidogrel-treated subjects did not inhibit PLADP . Conclusion The antiplatelet effect of ticagrelor cannot be fully reversed by donor platelets, which could be explained by the presence of active drug. The effect of residual drug on donor platelets appears to be evident for at least 10 hours after ticagrelor ingestion. |
| Databáze: | OpenAIRE |
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