IMR Press / RCM / Volume 23 / Issue 9 / DOI: 10.31083/j.rcm2309300
Open Access Review
Reversal of Platelet Inhibition in Patients Receiving Ticagrelor
Show Less
1 Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
2 Clinic of Cardiology and Cardiac Care Unit Department, Provincial Polyclinic Hospital, 87-100 Toruń, Poland
3 Department of Cardiology and Department of Cardiological Intensive Care, Provincial Hospital, 82-300 Elbląg, Poland
4 Department of Cardiology and Internal Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland
5 Department of Cardiology, Regional Specialist Hospital, 10-082 Olsztyn, Poland
*Correspondence: piotr.adamski@cm.umk.pl (Piotr Adamski)
Academic Editors: Domenico D’Amario and Mattia Galli
Rev. Cardiovasc. Med. 2022, 23(9), 300; https://doi.org/10.31083/j.rcm2309300
Submitted: 28 June 2022 | Revised: 6 August 2022 | Accepted: 8 August 2022 | Published: 5 September 2022
(This article belongs to the Special Issue Antiplatelet Therapy in Cardiovascular Disease)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Antiplatelet treatment is one of the pillars of contemporary therapy in acute coronary syndromes. It is based on dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 receptor inhibitor. Antiaggregatory treatment reduces ischemic events, but at cost of increased bleeding rates. As a result of irreversible inhibition of platelet P2Y12 receptors, the antiplatelet action of clopidogrel and prasugrel is prolonged for the lifespan of thrombocytes and lasts up to 7 days. The antiaggregatory effect of ticagrelor may persist up to 5 days despite its reversible nature of P2Y12 receptor inhibition. These pharmacodynamic properties may prove problematic in patients requiring immediate reversal of antiplatelet effects due to severe or life-threatening bleeding, or in presence of indications for an urgent surgery. The current review summarizes available knowledge on different strategies of restoring platelet function in patients treated with ticagrelor. Non-specific methods are discussed, including platelet transfusion, human albumin supplementation and hemadsorption. Finally, bentracimab, the first specific antidote for ticagrelor, and in fact against any antiplatelet agent, is described.

Keywords
antidote
bentracimab
MEDI2452
PB2452
platelet transfusion
ticagrelor
Figures
Fig. 1.
Share
Back to top