cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2024-3970IXYWYJcardiovascular-3970Research ArticleКЛИНИКА И ФАРМАКОТЕРАПИЯCLINIC AND PHARMACOTHERAPYЧастота одышки, связанной с приемом тикагрелора или клопидогрела, у пациентов с хроническим коронарным синдромом, перенесших коронарное вмешательствоFrequency of dyspnea related to intake of ticagrelor or clopidogrel in patients with chronic coronary syndrome undergoing coronary interventionhttps://orcid.org/0009-0006-6090-1662ShnainDunya HabeebShnainDunya Habeeb

Куфа

PhD, Clinical Pharmacy.

Kufa

duniahabeeb67@gmail.comhttps://orcid.org/0009-0001-6772-763XMahmoodGhassan MohammedMahmoodGhassan Mohammed

Багдад

PhD.

Baghdad

https://orcid.org/0009-0000-9277-3470AhmedSara OmarAhmedSara Omar

Багдад

PhD, Clinical Pharmacy.

Baghdad

za4389452@gmail.comDepartment of Clinical Pharmacy, Faculty of Pharmacy, University of KufaDepartment of Clinical Pharmacy, Faculty of Pharmacy, University of KufaBaghdad Heart Center/Medical CityBaghdad Heart Center/Medical CityAshur University, Faculty of PharmacyAshur University, Faculty of Pharmacy20242904202423539703970Copyright © Shnain D.H., Mahmood G.M., Ahmed S.O., 20242024Shnain D.H., Mahmood G.M., Ahmed S.O.Shnain D.H., Mahmood G.M., Ahmed S.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3970

У пациентов с хроническим коронарным синдромом тикагрелор снижает частоту сердечно-сосудистых событий более эффективно, чем клопидогрел. Ряд исследований продемонстрировал появление одышки у пациентов, получающих новые блокаторы P2Y12-рецепторов. Предполагается, что при приеме тикагрелора это связано с повышением уровня аденозина в крови. Важно отметить, что одышка является распространенным и многогранным симптомом, ухудшающим качество жизни пациента и повышающим риск повторных госпитализаций.

Цель

Цель. Определить частоту развития одышки, связанной с приемом тикагрелора или клопидогреля, у пациентов со стабильной ишемической болезнью сердца (ИБС), перенесших коронарное вмешательство. Также определить когорты пациентов, которым необходимо продолжать или прекращать прием тикагрелора, и показать причины отмены тикагрелора.

Материал и методы

Материал и методы. В период с октября 2023г по январь 2024г в Багдадском кардиологическом центре было проведено наблюдательное проспективное сравнительное исследование "случай-контроль". В него были включены лица со стабильной ИБС, которым была проведена коронарная ангиопластика с последующим назначением двойной антиагрегантной терапии. Больные 1-й группы получали аспирин и тикагрелор, 2-й группы — аспирин и клопидогрел.

Результаты

Результаты. Всего быловключено 120 пациентов. При приеме тикагрелора в 64,2% (77 [120]) и 19,1% (23 [120]) выявлялась легкая и умеренная одышка, соответсвтенно. Около 16,7% (20 [120]) не имели одышки. Разница между пациентами, продолжавшими прием тикагрелора (16%), и теми, кто прекратил его прием (84%), была значительной. При приеме клопидогрела появление одышки не была зафиксировано.

Заключение

Заключение. По нашим данным, возникновение одышки доказано только у пациентов, получавших тикагрелор. По сравнению с необратимыми ингибиторами P2Y12, такими как клопидогрел, обратимый антагонист P2Y12 тикагрелор имеет более высокую частоту возникновения одышки.

In patients with chronic coronary syndrome, ticagrelor decreases cardiovascular events more efficiently than clopidogrel. In several studies investigating novel P2Y12 inhibitors dyspnea has been detected. A rise of adenosine blood levels is supposed to be one of cases of dyspnea induced by ticagrelor. Dyspnea is a prevalent and complex symptom. It is associated with deterioration of the quality of life and hospital readmission.

Aim

Aim. To determine the frequency of dyspnea related with ticagrelor or clopidogrel intake in patients with stable coronary artery disease undergoing coronary intervention. Also, to determine which patients could continue ticagrelor intake and which patients couldn’t, and show the causes of ticagrelor discontinuation.

Material and methods

Material and methods. Between October 2023 and January 2024, an observational prospective comparative case-control study was conducted at Baghdad Heart Center in Baghdad Teaching Hospital in Medical City. In this study, individuals with stable coronary artery disease who just had therapeutic catheterization and dual antiplatelet therapy were included. The patients from group 1 received aspirin and ticagrelor, while those from group 2 received aspirin and clopidogrel.

Results

Results. A total of 120 patients were included. With the ticagrelor intake, the severity of dyspnea was classified as mild 64.2% (77 [120]) and moderate 19.1% (23 [120]). About 16.7% (20 [120]) had no dyspnea at all. The difference between patients who continued ticagrelor intake (16%) and those who stopped using it (84%) was significant. With clopidogrel intake no dyspnea was recorded.

Conclusions

Conclusions. According to our findings, the risk or occurrence of dyspnea is only evident in patients who received ticagrelor. When compared to irreversible P2Y12 inhibitors like clopidogrel, the reversible P2Y12 antagonist ticagrelor has a higher incidence of dyspnea in increasing order.

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The authors declare that there are no conflicts of interest present.