Key result
Low-dose ticagrelor is linked to ~66% lower platelet reactivity vs standard clopidogrel in stable CAD.
Why the study?
The applicability of a low-dose ticagrelor regimen in a heterogeneous Trinidadian subpopulation with stable coronary artery disease was unexplored.
Does low-dose ticagrelor reduce platelet reactivity compared to clopidogrel in patients with stable coronary artery disease?
Does low-dose ticagrelor reduce platelet reactivity compared to clopidogrel in patients with stable coronary artery disease?
Absolute Event Rate: 50.4% vs 149.6%
p-value: p=<0.001
Low-dose ticagrelor (45 mg twice daily) significantly attenuates platelet reactivity compared to clopidogrel in Trinidadian patients with stable coronary artery disease.
Hypothesis-generating for low-dose ticagrelor in stable CAD; leaves open whether greater platelet inhibition improves outcomes.
INTRODUCTION: This prospective, pharmacodynamic study aimed to explore the potential applicability of a low-dose ticagrelor regimen in a heterogeneous Trinidadian subpopulation. METHODS: assay (Accriva Diagnostics, San Diego, CA, USA) and assessed before initiation of and after 14 days of treatment with a low-dose ticagrelor 45 mg twice daily maintenance dose regimen. Results were compared with a paired t test. RESULTS: reaction units (PRU) score on ticagrelor was significantly less compared to that of clopidogrel (50.4, 95% confidence interval (CI) 29-73.9; vs. 149.6, 95% CI 129.4-169.9; p value < 0.001). Of the patients, 4% experienced Medical Research Council class 1 dyspnea, and Bleeding Academic Research Consortium class 1 bleeding on the ticagrelor regimen (one patient each). CONCLUSIONS: Significantly attenuated platelet reactivity was seen on the low ticagrelor maintenance dose as compared to clopidogrel. This dedicated pharmacodynamic study could be applicable and informative for Trinidadian stable coronary artery disease patients. Further studies are required to confirm these exploratory findings.(Funded by the University of the West Indies, St. Augustine). TRIAL REGISTRATION: ClinicalTrials.gov number NCT04206176.
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Seecheran et al. (2020) studied Stable coronary artery disease (n=25). Low-dose ticagrelor vs. Clopidogrel 75 mg once daily was evaluated on Platelet reactivity measured by VerifyNow P2Y12 reaction units (PRU) (p=<0.001). Low-dose ticagrelor significantly attenuated platelet reactivity compared to standard-dose clopidogrel (mean PRU 50.4 vs 149.6, p<0.001) in Trinidadian patients with stable coronary artery disease.
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