Evidence map›Paper›PMID 40510620›Full record

ArticleTherapeutics and clinical risk management2025

Muscular and Renal Safety of Ticagrelor with High-Intensity Statins: Retrospective Cohort Findings.

Abdullah S Alshammari, Amer A Shalwala, Mohammed A Alnuhait, Abdulfattah Y Alhazmi, Refal E Fagieha, Nura Bin Hallabi, Eyad A Alandijani, Mansour A Aloufi, Mudhhi S Alharbi, Reem S Alzahrani and 3 more

Abstract read
In one paragraph

Article in Therapeutics and clinical risk management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Abdullah S AlshammariPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Amer A ShalwalaPharmacy Department, King Abdulaziz Hospital, Makkah, Saudi Arabia.
Mohammed A AlnuhaitPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.ORCID 0000-0002-5279-5437
Abdulfattah Y AlhazmiPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Refal E FagiehaPharmaceutical Services Department, King Abdullah Medical City, Makkah, Saudi Arabia.
Nura Bin HallabiPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Eyad A AlandijaniPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Mansour A AloufiPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Mudhhi S AlharbiPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Reem S AlzahraniPharmaceutical Company, Al nahdi Medical Company, Dammam, Saudi Arabia.
Emad M ElkholyPharmaceutical Services Department, King Abdullah Medical City, Makkah, Saudi Arabia.
Mahmoud E ElrggalDepartment of Pharmacology and Toxicology, Faculty of Medicine, Al-Qunfudah, Umm Al-Qura University, Makkah, Saudi Arabia.
Abdulmalik S AlotaibiPharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.ORCID 0000-0002-4336-1901

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Ticagrelor is a widely used antiplatelet agent approved in over 70 countries, including the European Union and the United States, for reducing thrombotic events in patients with acute coronary syndromes (ACS). In clinical practice, combining ticagrelor with high-intensity statins is considered standard therapy for ACS. However, recent pharmacodynamic studies and case reports suggest potential drug-drug interactions that may increase the risk of adverse events, particularly muscular and renal complications. This study aimed to evaluate these risks in a real-world clinical setting in Saudi Arabia. Methods: This retrospective observational cohort study was conducted at the Makkah Cardiology Center, Saudi Arabia. The study included adult patients (n = 577) who were prescribed high-intensity statins, with or without concurrent ticagrelor. The primary outcomes were the incidence of statin-associated muscular complications-defined as myalgia, myopathy, myositis, or rhabdomyolysis-and acute kidney injury (AKI). Clinical data were extracted from the hospital information system, and statistical comparisons were conducted between patients receiving statin monotherapy and those receiving combination therapy. Results: The cohort consisted predominantly of male patients (74.5%). Muscle-related complications were significantly more common in the group receiving both ticagrelor and statins (20.2%) compared to the statin-only group (10.5%) (P = 0.001). Among comorbid conditions, hypertension was the only factor significantly associated with a higher incidence of muscle-related complications. Although a trend toward increased AKI incidence was observed in the combination therapy group, this difference did not reach statistical significance. Conclusion: This study highlights potential safety concerns related to the co-administration of ticagrelor and high-intensity statins, particularly the increased risk of muscle-related complications. While the findings on AKI were inconclusive, the results support the need for cautious use of this combination and call for larger prospective studies to further evaluate its safety profile and optimize treatment strategies.

Indexed as

acute kidney injuryatorvastatinrosuvastatinstatin-associated muscle symptomsticagrelor

Identifiers

PMID40510620
PMCPMC12161285

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