Key result
Ticagrelor cuts recurrent angina ~75% vs clopidogrel in ACS post-PCI but increases dyspnea.
Why the study?
The clinical effect and safety of ticagrelor administration in ACS patients following PCI required retrospective analysis.
Does ticagrelor improve clinical outcomes and platelet inhibition compared to clopidogrel in ACS patients following PCI?
RCT (n=203)
Randomly divided
No
Does ticagrelor improve clinical outcomes and platelet inhibition compared to clopidogrel in ACS patients following PCI?
Absolute Event Rate: 2.1% vs 8.3%
p-value: p=0.05
Ticagrelor provides superior platelet inhibition and reduces recurrent angina compared to clopidogrel in ACS patients post-PCI, though it is associated with a higher rate of dyspnea.
Supports preferring ticagrelor over clopidogrel in ACS post-PCI to reduce recurrent angina; confirms efficacy with dyspnea trade-off.
The aim of the present study was to retrospectively analyze the clinical effect and safety of ticagrelor administration in acute coronary syndrome (ACS) patients following percutaneous coronary intervention (PCI). In total, 203 patients were enrolled, who were confirmed with ACS between March 2013 and May 2013, and had successfully undergone PCI. The patients were randomly divided into two groups, including the clopidogrel (group A, n=108) and ticagrelor groups (group B, n=95). Patients in group A were treated with a 600 mg loading dose of clopidogrel followed by 75 mg/day clopidogrel plus 100 mg/day aspirin. Patients in group B received a 180 mg loading dose of ticagrelor followed by 90 mg ticagrelor twice daily plus 100 mg/day aspirin. Light transmission aggregometry was performed to measure the platelet aggregation rate prior to and following 4 weeks of anti-platelet drug treatment. In addition, the rate of cardiovascular events and the adverse drug reactions were recorded within a 1-year treatment period. Compared with the clopidogrel group, the rate of recurrent angina in the ticagrelor group was significantly lower (P=0.05). However, the rate of dyspnea in the ticagrelor group was significantly higher when compared with that in the clopidogrel group (P=0.03). After 4 weeks of treatment, the reduction in the platelet aggregation rate was significantly different between the two groups (P<0.05). Therefore, ticagrelor, which is a novel antiplatelet aggregation drug, may reduce the rate of the adverse cardiovascular events in ACS patients following PCI, but a higher incidence of side-effects, such as dyspnea, may be observed.
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Lu et al. (2016) conducted an RCT in Acute coronary syndrome following percutaneous coronary intervention (n=203). Ticagrelor vs. Clopidogrel (600 mg loading dose, followed by 75 mg/day plus 100 mg/day aspirin) was evaluated on Recurrent angina (p=0.05). Ticagrelor reduced the rate of recurrent angina to 2.1% compared to 8.3% with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention, though it increased the incidence of dyspnea.
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