Ticagrelor in the treatment of patients with acute coronary syndrome: own clinical experience

Abstract

Purpose: To assess the safety (in terms of risk of bleeding) of the use of ticagrelor in patients with the
highest risk of vascular complications, namely in patients with ACS.
Material and methods: The study included 82 patients with ACS on the ECG and the onset of symptoms
of the disease not more than 24 hours ago. All patients were male. During hospitalization, in most cases, PCI with stenting of the coronary arteries was performed – in 81 patients (98,8%), in 1 case, after
coronary angiography, there was no need for stenting, and this patient was recommended conservative
treatment. The severity of bleeding was determined according to the criteria of the TIMI group. The new
ORACLE scale was used for the reference assessment of bleeding risk. From the moment of admission to
the hospital, all patients were prescribed ticagrelor at a loading dose of 180 mg, followed by a transition to
a maintenance dose of 90 mg 2 times per day. After discharge from the hospital, all patients were recommended to take dual antiplatelet therapy (DAT): ticagrelor at a dose of 90 mg/day and aspirin at a dose of
75 mg/day. In addition to DAT, all patients received standard therapy.
Results: The presented study supports the combination of acetylsalicylic acid with ticagrelor in the treatment of patients with various types of ACS, even in cases of PCI. The ORACLE scale is quite informative and
can be widely introduced into the clinical practice of ACS treatment to assess the risk of bleeding while
24 Вестник экстренной медицины, 2022, том 15, № 6
taking DAT. When prescribing a combination of ticagrelor with acetylsalicylic acid, in addition to assessing the risk of bleeding, it is imperative to take into account the gastralgic / ulcerative history and timely
conduct gastroprotective therapy. In our work, taking ticagrelor as part of DAT had no negative effects on
the main blood parameters and coagulograms, which once again proves its effectiveness and safety in the
treatment of this category of patients.
Conclusion: Thus, the data obtained can be considered as additional material in the evidence base of the
potential benefit from the use of ticagrelor as part of DAT in patients with ACS.