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Adrenaline Improves Platelet Reactivity in Ticagrelor-Treated Healthy Volunteers
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiothoracic Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiothoracic Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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2019 (English)In: Thrombosis and Haemostasis, ISSN 0340-6245, Vol. 119, no 5, p. 735-743Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Administration of agents that enhance platelet reactivity may reduce the perioperative bleeding risk in patients treated with the adenosine diphosphate (ADP)-receptor antagonist ticagrelor. Adrenaline potentiates ADP-induced aggregation and activation in blood samples from ticagrelor-treated patients, but it has not previously been evaluated in vivo.

METHODS: Ten healthy male subjects were included in an interventional study. A loading dose of ticagrelor (180 mg) was administered, followed 2 hours later by a gradually increased intravenous adrenaline infusion (0.01, 0.05, 0.10 and 0.15 µg/kg/min; 15 minutes at each step). Blood pressure, heart rate, platelet aggregation (impedance aggregometry), platelet activation (flow cytometry), clot formation (rotational thromboelastometry) and adrenaline plasma concentration were determined before and after ticagrelor administration and at the end of each adrenaline step.

RESULTS:  = 0.007).

CONCLUSION: Infusion of adrenaline at clinically relevant doses improves in vivo platelet reactivity and clot formation in ticagrelor-treated subjects. Adrenaline could thus potentially be used to prevent perioperative bleeding complications in ticagrelor-treated patients. Studies in patients are necessary to determine the clinical importance of our observations.

TRIAL REGISTRY NUMBER: ClinicalTrials.gov NCT03441412.

Place, publisher, year, edition, pages
Georg Thieme Verlag KG, 2019. Vol. 119, no 5, p. 735-743
Keywords [en]
adrenaline, ticagrelor, platelet function, flow cytometry, impedance aggregometry
National Category
Anesthesiology and Intensive Care Hematology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-72786DOI: 10.1055/s-0039-1683461ISI: 000467408100008PubMedID: 30780166Scopus ID: 2-s2.0-85065206111OAI: oai:DiVA.org:oru-72786DiVA, id: diva2:1291850
Funder
Swedish Heart Lung Foundation, 20150587Region Västra Götaland, ALFGBG-725131Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-06-19Bibliographically approved

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Ramström, Sofia

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