Incidence and Causes for Early Ticagrelor Discontinuation: A "Real-World" Dutch Registry Experience.


OBJECTIVES The PLATO trial revealed superiority of ticagrelor over clopidogrel for the prevention of atherothrombotic events in patients with acute coronary syndrome. However, adverse events such as bleeding, dyspnea, and bradycardia were frequently reported, potentially leading to excess early ticagrelor discontinuation (ETD), later confirmed in the PEGASUS trial. We here evaluated the incidence and causes for ETD in a real-world patient cohort in a high-volume nonacademic percutaneous coronary intervention center in the Netherlands. METHODS In a retrospective single-center registry, all patients discharged from the hospital with a new ticagrelor prescription were screened for ETD. Follow-up data were obtained using the hospital electronic patient file records and confirmed by telephone contact with the patient and/or general practitioner, if necessary, to complement the data. RESULTS Ticagrelor was prescribed in 354 patients between December 2011 and December 2012. The follow-up data were available in 301 patients with a mean follow-up duration of 330 days. ETD or switching to another antiplatelet agent occurred in 73 patients (24.3%), mostly due to dyspnea (11.6%), bleeding (3.7%), or planned major surgery (2.7%). CONCLUSIONS Almost one quarter of ticagrelor patients were discontinued prematurely or switched to another antiplatelet agent within 1 year, mostly due to dyspnea or bleeding.

DOI: 10.1159/000475705

Cite this paper

@article{Bergmeijer2017IncidenceAC, title={Incidence and Causes for Early Ticagrelor Discontinuation: A "Real-World" Dutch Registry Experience.}, author={Thomas O. Bergmeijer and Paul Willem A Janssen and Mathijs van Oevelen and Dymphie van Rooijen and Thea Cornelia Godschalk and Johannes Christiaan Kelder and Vera H.M. Deneer and Victor L. Serebruany and Jurrien M ten Berg}, journal={Cardiology}, year={2017}, volume={138 3}, pages={164-168} }