Efficacy and safety of ticagrelor

Current antiplatelet medications such as clopidogrel, used in addition to aspirin, exhibit pharmacodynamic properties that limit their clinical efficacy. Ticagrelor is the first reversibly binding oral P2Y 12 receptor antagonist that belongs to the new class of non-thienopyridine platelet inhibitors. It exerts its effect on platelet P2Y 12 receptor with a constant, dose-dependent level, and with an immediate decline just after drug discontinuation, making it an eligible drug for antiplatelet therapy also when unexpected surgery may be needed. In clinical phase II and III trials, ticagrelor displays more consistent and superior platelet inhibition throughout therapy compared to conventional clopidogrel without an increased risk of bleeding. At the light of these findings, ticagrelor has been recently inserted in the last version of both ACCF/AHA/SCAI and ESC Guidelines for the management of acute coronary syndromes treated or not with invasive strategy. Keywords: ticagrelor; anti-platelet therapy; coronary artery disease. Received: January 15, 2013; Accepted: March 14, 2013; Published: May 26, 2013 Corresponding Author: Annunziata Nusca, MD, Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy. E-mail: a.nusca@unicampus.it .