Pioneering South Yorkshire launches new drug for heart attack victims

Pioneering South Yorkshire launches new drug for heart attack victims

Ticagrelor, a new drug that could prevent one in five heart attack deaths, has this month been launched as a new treatment for heart attack victims across South Yorkshire, replacing the standard treatment clopidogrel for many patients admitted to hospital.

Robert Storey, Professor of Cardiology at the University of Sheffield's Department of Cardiovascular Science and Academic Director of the Cardiology and Cardiothoracic Directorate, Sheffield Teaching Hospitals NHS Foundation Trust, has led UK investigations into the drug for the past 15 years.

He said: "South Yorkshire is leading the way in adopting this novel treatment which has been shown to save lives compared to the standard treatment, clopidogrel, which is still widely used around the world.

"Many hospitals in the UK and other countries have not yet introduced ticagrelor because of concerns about higher cost compared to clopidogrel, but the verdict released in October 2011 by NICE that ticagrelor is a cost-effective use of NHS resources opened the door to adopting this treatment in accordance with European Society of Cardiology guidelines."

Professor Storey was a member of the international committee that conducted the PLATO study, a trial of over 18,000 patients in over 40 countries around the world. The results of the PLATO study were first presented at the European Society of Cardiology congress in 2009, showing that ticagrelor was more effective for heart attack patients than clopidogrel in reducing death and recurrent heart attack. Further analyses of the PLATO study will be presented in March at the American College of Cardiology meeting in Chicago.

Ticagrelor was made available in the UK in December 2010 but has not yet been adopted across most of the UK due to cost concerns. Clopidogrel has a very low cost as it is available in generic forms, whereas ticagrelor is more expensive at around £55 per month. However, the excess drug cost of ticagrelor is offset to some extent by its greater effectiveness which reduces the need for heart operations.

One of the problems with clopidogrel is that about a quarter of people in the UK have a genetic variant that reduces the effect of the drug, leaving them at greater risk. A sub-study of the PLATO trial was published in the Lancet confirming that patients treated with clopidogrel, who have such a genetic variant, have a slightly higher risk in the first month following heart attack. However, ticagrelor is not affected by this variant and is still more effective than clopidogrel, regardless of a patient's genetic make-up.

A common side-effect of ticagrelor is a sense of breathlessness which is usually mild and well-tolerated. Professor Storey presented data at the European Society of Cardiology meeting in 2010 showing that even patients who develop this side-effect seem to have the reduced mortality risk compared to clopidogrel-treated patients.

Another analysis led by Professor Storey showed that patients who develop breathlessness on ticagrelor do not show any problems on heart or lung tests, providing reassurance about the benign nature of ticagrelor-related breathlessness.

s: Ticagrelor is manufactured by pharmaceutical company AstraZeneca in Leicestershire. It is licensed by the European Medicines Agency for use, in combination with aspirin, in patients with acute coronary syndromes.

To find out more about the Department of Cardiovascular Science, visit the link below.