Ticagrelor in the treatment of patients with acute coronary syndrome: own clinical experience

Purpose: To assess the safety (in terms of risk of bleeding) of the use of ticagrelor in patients with thehighest risk of vascular complications, namely in patients with ACS.Material and methods: The study included 82 patients with ACS on the ECG and the onset of symptomsof the disease not more than 24 hours ago. All patients were male. During hospitalization, in most cases, PCI with stenting of the coronary arteries was performed – in 81 patients (98,8%), in 1 case, aftercoronary angiography, there was no need for stenting, and this patient was recommended conservativetreatment. The severity of bleeding was determined according to the criteria of the TIMI group. The newORACLE scale was used for the reference assessment of bleeding risk. From the moment of admission tothe hospital, all patients were prescribed ticagrelor at a loading dose of 180 mg, followed by a transition toa maintenance dose of 90 mg 2 times per day. After discharge from the hospital, all patients were recommended to take dual antiplatelet therapy (DAT): ticagrelor at a dose of 90 mg/day and aspirin at a dose of75 mg/day. In addition to DAT, all patients received standard therapy.Results: The presented study supports the combination of acetylsalicylic acid with ticagrelor in the treatment of patients with various types of ACS, even in cases of PCI. The ORACLE scale is quite informative andcan be widely introduced into the clinical practice of ACS treatment to assess the risk of bleeding while24 Вестник экстренной медицины, 2022, том 15, № 6taking DAT. When prescribing a combination of ticagrelor with acetylsalicylic acid, in addition to assessing the risk of bleeding, it is imperative to take into account the gastralgic / ulcerative history and timelyconduct gastroprotective therapy. In our work, taking ticagrelor as part of DAT had no negative effects onthe main blood parameters and coagulograms, which once again proves its effectiveness and safety in thetreatment of this category of patients.Conclusion: Thus, the data obtained can be considered as additional material in the evidence base of thepotential benefit from the use of ticagrelor as part of DAT in patients with ACS.