Ticagrelor use and practice patterns among Canadian cardiac surgeons.

The P2Y12 platelet receptor inhibitor ticagrelor is widely used in patients following acute coronary syndromes or in those who have received coronary stents. Bentracimab is a monoclonal antibody-based reversal agent that is being formally evaluated in a Phase 3 clinical trial. Here, we probe the knowledge, attitudes, and practice patterns of cardiac surgeons regarding their perioperative management of ticagrelor and potential application of a ticagrelor reversal agent. A questionnaire was developed by a working group of cardiac surgeons to inquire into participants' practices and beliefs regarding ticagrelor and disseminated to practicing, Canadian-trained cardiac surgeons. A total of 70 Canadian-trained cardiac surgeons participated. Bleeding risk was identified as the most significant consideration when surgically revascularizing ticagrelor-treated patients (90%). There is variability in the duration of withholding ticagrelor before coronary artery bypass graft procedure in a stable patient; 44.3% wait 3 days and 32.9% wait 4 days or longer. Currently, 15.7% of cardiac surgeons prophylactically give platelet transfusions and fresh frozen plasma intraoperatively following protamine infusion in patients who have recently received ticagrelor. Interestingly, 47.1% of surveyed surgeons were aware of a reversal agent for ticagrelor, 91.4% of cardiac surgeons would consider utilizing a ticagrelor reversal agent if available, and 51.4% acknowledged that the introduction of such an agent would be a major advance in clinical practice. The present survey identified ticagrelor-related bleeding as a major concern for cardiac surgeons. Surgeons recognized the significant unmet need that a ticagrelor reversal agent would address. © 2021 Wiley Periodicals LLC.

Citation

Ahmad Makhdoum, Nitish K Dhingra, Aathmika Kirubaharan, Rachel Eikelboom, Jessica Luc, Olina Dagher, Joel Bierer, Andreanne Cartier, Olivier Vaillancourt, Thin X Vo, Keir Forgie, Gianluigi Bisleri, Terrence M Yau, Subodh Verma, Bobby Yanagawa. Ticagrelor use and practice patterns among Canadian cardiac surgeons. Journal of cardiac surgery. 2021 Aug;36(8):2793-2801

Mesh Tags

Substances

PMID: 34028081

search → result