Why the study?
Do adenosine and ticagrelor plasma levels differ between patients with and without ticagrelor-related dyspnea?
Do adenosine and ticagrelor plasma levels differ between patients with and without ticagrelor-related dyspnea?
Simultaneous measurement of adenosine and ticagrelor plasma levels may help elucidate the mechanism of ticagrelor-related dyspnea.
Supports mechanistic research on ticagrelor dyspnea; should not yet change clinical practice.
Dyspnea is a common side effect of ticagrelor, leading to drug discontinuation in roughly one in every 20 treated patients. Studies have suggested that ticagrelor inhibits the sodium-independent equilibrative nucleoside transporter-1, which may increase adenosine plasma levels and explain drug-related dyspnea. However, the identification of a pattern of periodic breathing associated to increased chemosensitivity to hypercapnia in patients with ticagrelor-related dyspnea has reinforced the hypothesis that this side effect may result from direct inhibition of P2Y receptors on neurons leading to purinergic stimulation of the chemoreflex system. Simultaneous measurements of adenosine and ticagrelor plasma levels in patients with and without dyspnea while on treatment with ticagrelor may help unraveling the mechanism of this common and clinically relevant side effect.
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Ortega‐Paz et al. (2018) studied this question.
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