Ticagrelor: The first approved reversible oral antiplatelet agent

Platelet aggregation plays an important role in the pathophysiology of acute coronary syndrome (ACS). Aspirin is the most widely used antiplatelet agent and acts by inhibiting thromboxane A(2)-induced platelet activation. But it does not prevent platelets activation and aggregation by other signaling pathways like adenosine diphosphate (ADP) and Glycoprotein IIb/IIIa. Ticagrelor is the first oral reversible ADP (P2Y12) receptor antagonist. As compared to clopidogrel, ticagrelor has rapid onset as well as offset of action because of its reversible binding to P2Y12 receptor. It has potential to change the standard drug therapy of patient of ACS as shown in Platelet inhibition and patient outcomes (PLATO) trial, but long-term studies are required to further evaluate its efficacy and safety in these patients.