Key result
ABCB1 T allele linked to ~155% higher risk of ticagrelor-related dyspnea.
Why the study?
The study was conducted to determine the effect of ABCB1 genetic polymorphism and renal function on the occurrence of ticagrelor-related dyspnea.
Observational (n=299)
Odds Ratio: 2.55
p-value: p=0.04
In patients with acute coronary syndrome, ticagrelor-related dyspnea is associated with the ABCB1 T allele, impaired renal function, and lower platelet aggregation.
May aid dyspnea risk stratification in ticagrelor-treated ACS; leaves open prospective validation before clinical use.
Purpose: The aim of this study was to determine the effect of ABCB1 genetic polymorphism and renal function on the occurrence of ticagrelor-related dyspnea. Patients and Methods: A total of 299 patients with acute with type 1, 2, or 3 myocardial infarction (with and without ST-segment elevation), who underwent coronary angiography and PTCA with stent implantation and were treated with antiplatelet drugs (ticagrelor and aspirin), were enrolled in this prospective study. For all enrolled patient’s platelet aggregation (induction with high-sensitivity adenosine diphosphate, ADP HS) testing was performed using a MULTIPLATE ® analyzer. Venous blood was also collected for genotyping. Results: Patients experiencing ticagrelor-related dyspnea had lower ADP HS value (ADP HS ≤ 19.5 U; OR = 2.254; P = 0.009), higher creatinine concentration (> 90 μmol/l; OR = 3.414; P = 0.019), and lower GFR value (< 60 mL/min/1.73 m 2 ; OR = 2.211; P = 0.035). ABCB1 T allele was associated with ticagrelor-related dyspnea (OR = 2.550; P = 0.04). Conclusion: Ticagrelor-related dyspnea was found to be related to low platelet aggregation, increased plasma creatinine concentration, decreased GFR, and ABCB1 T allele. Carriers of the ABCB1 T allele had a higher plasma creatinine concentration that could be associated with an inhibitory effect of ticagrelor on P-glycoprotein function.
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Tamakauskas et al. (2024) conducted an observational in Acute Coronary Syndrome (n=299). ABCB1 T allele, low platelet aggregation, and impaired renal function vs. Absence of these risk factors was evaluated on Ticagrelor-related dyspnea (OR 2.550, p=0.04). The ABCB1 T allele (OR 2.550; P=0.04), low platelet aggregation, and impaired renal function were significantly associated with the development of ticagrelor-related dyspnea.
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