Daniel Lindholm1, Robert F Storey2, Christina Christersson3, Sigrun Halvorsen4, Erik L Grove5, Oscar Ö Braun6, Christoph Varenhorst7, Stefan K James7. 1. Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala, Sweden. Electronic address: daniel.lindholm@ucr.uu.se. 2. Department of Cardiovascular Science, University of Sheffield, Sheffield, UK. 3. Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. 4. Department of Cardiology, Oslo University Hospital Ulleval and University of Oslo, Oslo, Norway. 5. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. 6. Department of Cardiology, Skåne University Hospital, Lund University, Lund, Sweden. 7. Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala, Sweden.
Abstract
BACKGROUND: Ticagrelor treatment has the side effect of increased incidence of dyspnea. Adenosine-induced dyspnea is augmented by ticagrelor and can be alleviated with the adenosine antagonist theophylline. Caffeine is a closely related xanthine derivative. OBJECTIVES: The primary objective of the TROCADERO is to evaluate the effect of caffeine versus placebo on ticagrelor-associated dyspnea, measured by the visual analog scale area under the curve in patients with ongoing ticagrelor treatment after an acute coronary syndrome event. DESIGN: After a run-in period of 1 to 7 days of absence of caffeine intake, acute coronary syndrome patients with ticagrelor-induced dyspnea (planned inclusion 416) are randomized in a blinded fashion to either caffeine 200 mg twice daily or matching placebo with a treatment duration of 1 week. The primary efficacy end point is change in visual analog scale area under the curve for dyspnea, and the primary safety end point is occurrence of high on-treatment platelet reactivity measured by the VerifyNow P2Y12 assay. CONCLUSIONS: This trial will determine if adenosine antagonism by caffeine can alleviate ticagrelor-related dyspnea, without impairing the antiplatelet effect of ticagrelor.
BACKGROUND:Ticagrelor treatment has the side effect of increased incidence of dyspnea. Adenosine-induced dyspnea is augmented by ticagrelor and can be alleviated with the adenosine antagonist theophylline. Caffeine is a closely related xanthine derivative. OBJECTIVES: The primary objective of the TROCADERO is to evaluate the effect of caffeine versus placebo on ticagrelor-associated dyspnea, measured by the visual analog scale area under the curve in patients with ongoing ticagrelor treatment after an acute coronary syndrome event. DESIGN: After a run-in period of 1 to 7 days of absence of caffeine intake, acute coronary syndromepatients with ticagrelor-induced dyspnea (planned inclusion 416) are randomized in a blinded fashion to either caffeine 200 mg twice daily or matching placebo with a treatment duration of 1 week. The primary efficacy end point is change in visual analog scale area under the curve for dyspnea, and the primary safety end point is occurrence of high on-treatment platelet reactivity measured by the VerifyNow P2Y12 assay. CONCLUSIONS: This trial will determine if adenosine antagonism by caffeine can alleviate ticagrelor-related dyspnea, without impairing the antiplatelet effect of ticagrelor.
Authors: Mohammed Ahmed Akkaif; Mei Li Ng; Muhamad Ali Sk Abdul Kader; Nur Aizati Athirah Daud; Abubakar Sha'aban; Baharudin Ibrahim Journal: Pharmacol Rep Date: 2021-07-20 Impact factor: 3.024
Authors: Remo H M Furtado; Ramkumar V Venkateswaran; Jose C Nicolau; Yared Gurmu; Deepak L Bhatt; Robert F Storey; P Gabriel Steg; Giuglia Magnani; Shinya Goto; Mikael Dellborg; Gabriel Kamensky; Daniel Isaza; Philip Aylward; Per Johanson; Marc P Bonaca Journal: J Am Heart Assoc Date: 2020-05-15 Impact factor: 5.501