Objective:

To identify risk factors for ticagrelor-induced dyspnea by testing plasma concentrations of ticagrelor and its active metabolite, along with other clinical factors.

Approach:

Key Findings:

• Compared with the non-dyspnea group, LDH levels decreased markedly in patients who developed dyspnea (OR=0.814 per 10 U/L, P = 0.027).
• The ticagrelor metabolite ratio (TMR) also decreased in the dyspnea group (OR=0.523 per 0.1 increase, P = 0.008).
• Peak ticagrelor concentration was higher in the dyspnea group (OR=1.173 per 100 ng/mL, P = 0.012).
• The plasma peak concentration of ticagrelor was negatively related to LDH (r = −0.316, P = 0.001).

Interpretation:

The peak concentration of ticagrelor, plasma LDH level, and the TMR are associated with ticagrelor-induced dyspnea in ACS patients.

Limitations:

• The study was conducted at a single center, which may limit generalizability.
• The sample size was relatively small, with only 23 patients experiencing dyspnea.

Conclusion:

Monitoring plasma concentrations of ticagrelor and its metabolite may be relevant in assessing dyspnea risk.

Source

Based on findings from:

Ticagrelor plasma concentration, metabolite ratio, and LDH level as independent risk factors for ticagrelor-induced dyspnea in ACS patients

Yazi Zhao, Mengqi Gong, Yong Su, Jiaxin Zhao, Fangde Hong, Zheyuan Lu, Mengqing Ma, Meijie Jiang, Youfeng Liang. Frontiers In Cardiovascular Medicine, 2026.

https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2026.1725673/full

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