{"doi":"10.3390/jcm12031149","title":"Ticagrelor Resistance in Cardiovascular Disease and Ischemic Stroke","abstract":"<jats:p>Ticagrelor, acting as a reversible platelet aggregation inhibitor of P2Y12 receptors (P2Y12R), is regarded as one of the first-line antiplatelet drugs for acute cardiovascular diseases. Though the probability of ticagrelor resistance is much lower than that of clopidogrel, there have been recent reports of ticagrelor resistance. In this review, we summarized the clinical application of ticagrelor and then presented the criteria and current status of ticagrelor resistance. We further discussed the potential mechanisms for ticagrelor resistance in terms of drug absorption, metabolism, and receptor action. In conclusion, the incidences of ticagrelor resistance fluctuated between 0 and 20%, and possible mechanisms mainly arose from its absorption and receptor action. Specifically, a variety of factors, such as the drug form of ticagrelor, gut microecology, and the expression and function of P-glycoprotein (P-gp) and P2Y12R, have been shown to be associated with ticagrelor resistance. The exact mechanisms of ticagrelor resistance warrant further exploration, which may contribute to the diagnosis and treatment of ticagrelor resistance.</jats:p>","journal":"Journal of Clinical Medicine","year":2023,"id":617773,"datarank":0.6249916998388405,"base_score":2.70805020110221,"endowment":2.70805020110221,"self_citation_contribution":0.40620753016533157,"citation_network_contribution":0.218784169673509,"self_endowment_contribution":0.40620753016533157,"citer_contribution":0.218784169673509,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":14,"citers_with_citation_signal":9,"citers_with_endowment":9,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1593317,"name":"Yapeng Lin","orcid":null,"position":1,"is_corresponding":false},{"id":1593318,"name":"Quandan Tan","orcid":null,"position":2,"is_corresponding":false},{"id":1593319,"name":"Fengkai Mao","orcid":null,"position":3,"is_corresponding":false},{"id":731489,"name":"Kejie Chen","orcid":"0000-0001-6591-5875","position":4,"is_corresponding":false},{"id":1593320,"name":"Junli Hao","orcid":null,"position":5,"is_corresponding":false},{"id":397727,"name":"Weidong Le","orcid":"0000-0001-7459-2705","position":6,"is_corresponding":false},{"id":1451894,"name":"Jie Yang","orcid":"0009-0008-5487-4439","position":7,"is_corresponding":false},{"id":1561228,"name":"Song He","orcid":"0000-0002-4136-6151","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Ticagrelor Resistance in Cardiovascular Disease and Ischemic Stroke","abstract":"<jats:p>Ticagrelor, acting as a reversible platelet aggregation inhibitor of P2Y12 receptors (P2Y12R), is regarded as one of the first-line antiplatelet drugs for acute cardiovascular diseases. Though the probability of ticagrelor resistance is much lower than that of clopidogrel, there have been recent reports of ticagrelor resistance. In this review, we summarized the clinical application of ticagrelor and then presented the criteria and current status of ticagrelor resistance. We further discussed the potential mechanisms for ticagrelor resistance in terms of drug absorption, metabolism, and receptor action. In conclusion, the incidences of ticagrelor resistance fluctuated between 0 and 20%, and possible mechanisms mainly arose from its absorption and receptor action. Specifically, a variety of factors, such as the drug form of ticagrelor, gut microecology, and the expression and function of P-glycoprotein (P-gp) and P2Y12R, have been shown to be associated with ticagrelor resistance. The exact mechanisms of ticagrelor resistance warrant further exploration, which may contribute to the diagnosis and treatment of ticagrelor resistance.</jats:p>","is_dataset_classified":null,"base_score":2.70805020110221,"endowment":2.70805020110221,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36769796","pmcid":"PMC9918175","openalex_id":"https://openalex.org/W4318820671","authors":[],"funders":[{"funder_name":"National Natural Science Foundation of China","grant_id":"82171295","title":null},{"funder_name":"National Natural Science Foundation of China","grant_id":"2020-GH02-00057-HZ","title":null},{"funder_name":"National Natural Science Foundation of China","grant_id":"2021YFS0376","title":null}],"total_grants":3,"fwci":2.4773,"citation_percentile":0.90577537,"influential_citations":3,"citation_trend":[{"year":2024,"count":2},{"year":2025,"count":6},{"year":2026,"count":6}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2077-0383/12/3/1149/pdf?version=1675247385","host_type":"journal"},{"url":"https://www.mdpi.com/2077-0383/12/3/1149/pdf?version=1675247385","host_type":"GOLD"},{"url":"https://www.mdpi.com/2077-0383/12/3/1149/pdf?version=1675247385","host_type":"publisher"},{"url":"https://www.mdpi.com/2077-0383/12/3/1149/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/jcm12031149","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36769796","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9918175","host_type":"repository"},{"url":"https://dx.doi.org/10.3390/jcm12031149","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9918175/pdf/jcm-12-01149.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC9918175","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC9918175?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Antiplatelet Therapy and Cardiovascular Diseases","Venous Thromboembolism Diagnosis and Management","Lipoproteins and Cardiovascular Health","Medicine"],"mesh_terms":[],"keywords":["Ticagrelor","Medicine","Antiplatelet drug","P2Y12","Clopidogrel","Pharmacology","Aspirin","Cardiology","Internal medicine","Genetics","Cardiovascular disease","Ischemic stroke","Epigenetics","High On-treatment Platelet Reactivity","Ticagrelor Resistance"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T02:36:22.491768Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}