Ticagrelor is a medication that is used to reduce the risk of heart attack and stroke in patients with a history of acute coronary syndrome (ACS). It is sold under the brand name Brilinta and is classified as a platelet aggregation inhibitor. Platelets are tiny cells in our blood that help to form clots to stop bleeding. However, in some cases, these clots can form inside our blood vessels and cause blockages that can lead to a heart attack or stroke. Ticagrelor works by preventing platelets from clumping together and forming these harmful clots. Ticagrelor was developed by AstraZeneca and was approved by the U.S. Food and Drug Administration (FDA) in 2011. It is available in the form of oral tablets and is typically prescribed in combination with aspirin. It is recommended for patients with a history of ACS, including unstable angina and heart attack, who have undergone percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) procedures. Ticagrelor is unique among platelet aggregation inhibitors in that it is a reversible inhibitor of the P2Y12 receptor. This means that it does not permanently bind to the receptor and can be quickly removed from the body's circulation if necessary. This is in contrast to other P2Y12 inhibitors, such as clopidogrel and prasugrel, which irreversibly bind to the receptor and have a longer duration of action. Ticagrelor is rapidly absorbed into the bloodstream after oral administration and reaches peak plasma concentrations within 1-3 hours. It has a half-life of approximately 7 hours, which means that it is cleared from the body relatively quickly. Ticagrelor is metabolized in the liver and is primarily excreted in the feces. Ticagrelor has been shown to be effective in reducing the risk of cardiovascular events in patients with ACS. In the PLATO trial, which compared ticagrelor to clopidogrel in over 18,000 patients with ACS, ticagrelor was found to be superior in reducing the incidence of cardiovascular death, heart attack, and stroke. Ticagrelor was also associated with a lower risk of stent thrombosis, a serious complication that can occur after PCI. Like all medications, ticagrelor can cause side effects. The most common side effects of ticagrelor include bleeding, shortness of breath, and nausea. Bleeding is the most serious side effect and can occur anywhere in the body. Ticagrelor may also increase the risk of bleeding in patients who are taking anticoagulant medications, such as warfarin. Ticagrelor is contraindicated in patients with a history of intracranial hemorrhage, active pathological bleeding, or severe hepatic impairment. It should also be used with caution in patients with a history of bleeding disorders or those who are undergoing surgery or invasive procedures. When treating coronary artery disease, a coronary artery stent is a tubular device that is put into the coronary artery that provides blood to the heart and maintains the artery open. It is employed in a procedure known as percutaneous coronary intervention (PCI). Coronary Stents are now used in more than 90% of PCI operations. Stents have been demonstrated to alleviate angina pectoris (chest discomfort), enhance survival rates, and lessen the adverse effects of a heart attack. Ticagrelor, also known as Brilinta, is a medicine used to prevent stroke, heart attack, and other occurrences in persons with acute coronary syndrome, which refers to difficulties with blood supply in the coronary arteries. It inhibits platelet aggregation by antagonising the P2Y12 receptor. AstraZeneca manufactures the medication. The most common side effects include dyspnea (breathing problems), bleeding, and an increase in uric acid levels in the blood. In the European Union, it was licenced for medicinal use in December 2010, and in the United States, it was approved in July 2011. With over 1 million prescriptions in 2020, it was the 247th most widely prescribed drug in the United States.
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