Furthermore, a patient on ticagrelor cannot undergo urgent CABG or other surgical procedures without increased bleeding risk unless treatment with ticagrelor is interrupted for 3 to 5 days, which increases the risks and causes discomfort for the patient as well as a prolonged hospital stay and higher health care costs. 3 Even though the study reached its primary end point and demonstrated a significant reduction in ischemic events, this reduction was matched by a similar number of bleeding complications. A denotes aspirin ACS, acute coronary syndrome CABG, coronary artery bypass graft surgery Creat, creatinine F, female Hep, heparin LMWH, low-molecular. In the recently published Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54 trial, patients with a myocardial infarction 1 to 3 years prior to enrollment were randomized to 2 different doses of ticagrelor vs placebo. 2 However, patients also experienced increased bleeding events not associated with coronary-artery bypass grafting (CABG).

In the Platelet Inhibition and Patient Outcomes trial, ticagrelor reduced the combined end point of death from vascular causes, myocardial infarction, or stroke for up to 12 months, and even reduced total mortality. Ticagrelor is a widely used reversible adenosine 5′-diphosphate (ADP) P2Y 12 antagonist for treatment of patients with acute coronary syndrome (ACS).

Aspirin antidote