TICAGRELOR’S ANTIPLATELET EFFECT IS MODIFIED BY ACIDIFICATION AND NITRITES, AND READILY FORMS NITROSOTHIOL COMPOUNDS TO AUGMENT ITS ANTIPLATELET EFFECT IN VITRO

Recent evidence suggests that when in an acidic milieu akin to that in the human stomach, clopidogrel forms S-nitrosothiols (RSNO) with anti-aggregatory and vasomodulatory effects. This effect relies on the availability of free thiol in the clopidogrel molecule. Ticagrelor however lacks a free thiol