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Ticagrelor and prasugrel are newer and stronger platelet P2Y12 receptor antagonists than their predecessor clopidogrel. Clopidogrel is a pro-drug requiring a 2-step hepatic activation processes. Speed of activation varies according to the cytochrome P-450 2C19 allele [1,2]. Ticagrelor is a direct non-thienopyridine P2Y12 antagonist producing equal or stronger inhibition of the P2Y12 receptor even when compared to the newer thienopyridine prasugrel [3].

Trials Evaluating Ticagrelor in Cardiovascular Disease: Will It Reign Supreme in the Anti-Platelet World?