Risk factors and mechanisms of ticagrelor-related dyspnoea from real-world evidence and network pharmacology

Introduction: In the clinical application of ticagrelor, dyspnoea is a common adverse event and is a significant factor leading to discontinuation of the drug. However, the molecular mechanisms of ticagrelor-related dyspnoea have not been definitively identified, and consequently, the therapeutic implications remain unclear. Methods: Data from the FDA Adverse Event Reporting System (FAERS) database were used. The analysis focused on asymmetry methods for ticagrelor-related dyspnoea adverse events (ADEs), including the reporting odds ratio (ROR) and the Bayesian confidence propagation neural network (BCPNN). Logistic regression analysed the impact of age, weight, and sex. Cumulative incidence and time to onset of dyspnoea events were examined and Weibull shape parameter tests. And the mechanism of ticagrelor-related dyspnoea was predicted using network pharmacology and molecular docking. Results: The results indicated that Logistic regression analysis suggested that female (adjusted odds ratio [aOR] 0.80, 95% confidence interval [CI] 0.69–0.93, P = 0.003), higher weight (aOR 2.57, 95% CI 1.57–4.48, P < 0.001), and older age (aOR 1.01, 95% CI 1.01–1.01, P < 0.001) were independent predictors of ticagrelor-related dyspnoea. The Weibull shape parameter β was