Chewing Ticagrelor Loading Dose May Benefit Patients With STEMI

Chewing facilitates better early platelet inhibition compared with standard oral loading dose
Chewing facilitates better early platelet inhibition compared with standard oral loading dose

(HealthDay News) — For patients with ST-segment elevation myocardial infarction (STEMI), chewing a loading dose (LD) of ticagrelor facilitates better early platelet inhibition, according to a study published online Oct. 25 in JAMA Cardiology.

Elad Asher, M.D., M.H.A., from Sheba Medical Center in Israel, and colleagues conducted a clinical trial involving 50 adult patients with STEMI who were randomized to chew an LD of ticagrelor (180 mg) or receive standard oral administration of the same dose.

The researchers found that at baseline, 30 minutes, and one and four hours after ticagrelor LD, the mean of P2Y12 reaction units in the chewing versus the standard group were 224 versus 219 (95 percent confidence interval [CI], −16.77 to 27.73; P = 0.26), 168 versus 230 (95 percent CI, −103.77 to −19.75; P = 0.003), 106 versus 181 (95 percent CI, −125.15 to −26.29; P = 0.005), and 43 versus 51 (95 percent CI, −36.34 to 21.14; P = 0.3), respectively. At 30 minutes after LD, platelet reactivity in the chewing group was reduced by 24 percent (95 percent CI, 19.75 to 103.77; P = 0.001). In the chewing versus the standard group, the relative inhibition of platelet aggregation was 51 versus 10 percent (95 percent CI, 13.69 to 67.67; P = 0.005) at one hour and 81 versus 76 percent (95 percent CI, −12.32 to 16.79; P = 0.24) at four hours.

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"Larger studies are warranted to see if our preliminary findings translate into clinical outcomes," the authors write.

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