Key result
Ticagrelor significantly reduced the incidence of ischemic events at 1 year compared to clopidogrel (4.0% vs 32.0%, p<0.001) in patients with acute coronary syndrome after percutaneous coronary intervention.
Why the study?
The study aimed to compare the efficacy of clopidogrel versus ticagrelor and their effects on IL-6 in patients with ACS after PCI.
Does ticagrelor improve platelet inhibition, reduce IL-6 expression, and prevent ischemic events compared to clopidogrel in patients with ACS after PCI?
RCT (n=200)
Randomly divided
No
Does ticagrelor improve platelet inhibition, reduce IL-6 expression, and prevent ischemic events compared to clopidogrel in patients with ACS after PCI?
Absolute Event Rate: 4% vs 32%
p-value: p=<0.001
Ticagrelor provides superior platelet inhibition, reduces inflammation (IL-6), and lowers ischemic events compared to clopidogrel in ACS patients post-PCI.
May support ticagrelor preference in ACS post-PCI; hypothesis-generating and requires prospective validation.
Background: We aimed to compare the efficacy between clopidogrel and ticagrelor in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) and their effects on IL-6. Methods: A retrospective analysis and collection of 200 ACS patients diagnosed by the Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China in 2016 were performed. Patients were randomly divided into clopidogrel group and ticagrelor group. Data of left ventricular ejection fraction and ACS clinical classification before PCI, PCI treatment, IL-6, platelet aggregation status, maximum platelet aggregation rate (MPAR), P2Y12 response unit (PRU) and adverse reaction of patients were collected. After PCI, patients were followed up for 1 year to compare the ischemia after treatment between clopidogrel group and tigravilol group. Results: MPAR and PRU after PCI of clopidogrel group were significantly higher than those of ticagrelor group (P<0.05). The expression of IL-6 in two groups peaked at 1 day after PCI and then decreased. That of ticagrelor group was consistently lower than that of clopidogrel group (P<0.05). The incidence of ischemic events after treatment in clopidogrel group was significantly higher than that in ticagrelor group (P<0.001). Conclusion: Compared with clopidogrel, tigerrilol had more significant inhibition of platelet aggregation after PCI in ACS patients, and tigerrilol had better effect after interventional treatment in ACS patients. In addition, compared with clopidogrel, tegrel can significantly inhibit the expression of IL-6 in patients with ACS and better alleviate the inflammatory response after PCI.
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Yang et al. (2020) conducted an RCT in Acute Coronary Syndrome (ACS) (n=200). Ticagrelor vs. Clopidogrel (300 mg loading dose before PCI, then 75 mg once daily, with aspirin) was evaluated on Incidence of ischemic events at 1 year (p=<0.001). Ticagrelor significantly reduced the incidence of ischemic events at 1 year compared to clopidogrel (4.0% vs 32.0%, p<0.001) in patients with acute coronary syndrome after percutaneous coronary intervention.
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