Observational studyClinical pharmacology and therapeutics2026
Population Pharmacokinetics of Ticagrelor during Veno-Arterial ECMO in Acute Coronary Syndrome: Model-Informed Dosing Simulations.
Observational study in Clinical pharmacology and therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although patients with acute coronary syndrome supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) have a high risk of thrombosis and bleeding, antiplatelet pharmacology in this setting is not well defined. This prospective observational study investigated the population pharmacokinetics of ticagrelor and its active metabolite AR-C124910XX and explored model-informed dosing strategies among this population. Paired pharmacokinetic sampling was performed at predefined time points during ON- and OFF-ECMO periods. Plasma concentrations were measured using a validated liquid chromatography-tandem mass spectrometry assay and analyzed with NONMEM to develop a joint parent-metabolite model and evaluate the effects of VA-ECMO status and flow rate on ticagrelor disposition. Monte Carlo simulations of various ECMO flow-rate scenarios examined alternative loading and maintenance regimens using prespecified trough concentrations of 180-360 ng/mL, as derived from previous exposure-response and exposure-bleeding analyses in non-ECMO populations. A total of 225 ticagrelor and 225 metabolite concentrations (127 ON-ECMO and 98 OFF-ECMO) from 20 patients were analyzed. VA-ECMO support was associated with reduced ticagrelor clearance and increased volume of distribution, while higher flow rates were associated with decreased volumes of distribution. In simulations, an initial loading dose of 120-135 mg followed by a 60 mg maintenance dose once daily most consistently maintained predicted trough concentrations within the target range during VA-ECMO, whereas 90 mg once daily frequently exceeded the upper bound. These findings indicate that VA-ECMO substantially altered ticagrelor pharmacokinetics and provided quantitative, model-informed support for reduced once daily dosing strategies; however, further pharmacokinetic-pharmacodynamic and outcome studies are needed to confirm these findings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.