Better Early Platelet Inhibition With Chewable Ticagrelor

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At 30 minutes after LD, platelet reactivity in the chewing group was reduced by 24%.
At 30 minutes after LD, platelet reactivity in the chewing group was reduced by 24%.

HealthDay News — For patients with ST-segment elevation myocardial infarction (STEMI), chewing a loading dose (LD) of ticagrelor facilitates better early platelet inhibition, according to a study published in JAMA Cardiology.

Elad Asher, MD, MHA, from Sheba Medical Center in Israel, and colleagues conducted a clinical trial involving 50 adult patients with STEMI who were randomized to chew an LD of ticagrelor (180 mg) or receive standard oral administration of the same dose.

The researchers found that at baseline, 30 minutes, and 1 and 4 hours after ticagrelor LD, the mean of P2Y12 reaction units in the chewing vs the standard group were 224 vs 219 (95% confidence interval [CI], −16.77 to 27.73; P = .26), 168 vs 230 (95% CI, −103.77 to −19.75; P = .003), 106 vs 181 (95% CI, −125.15 to −26.29; P = .005), and 43 vs 51 (95% CI, −36.34 to 21.14; P =.3), respectively. 

At 30 minutes after LD, platelet reactivity in the chewing group was reduced by 24% (95% CI, 19.75 to 103.77; P =.001). In the chewing vs the standard group, the relative inhibition of platelet aggregation was 51% vs 10% (95% CI, 13.69 to 67.67; P =.005) at 1 hour and 81% vs 76% (95% CI, −12.32 to 16.79; P = .24) at 4 hours.

"Larger studies are warranted to see if our preliminary findings translate into clinical outcomes," the authors write.

Reference

Asher E, Tal S, Mazin I, et al. Effect of chewing vs swallowing ticagrelor on platelet inhibition in patients with ST-segment elevation myocardial infarction [published online October 25, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.3868

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