Comparison of Clinical Effectiveness of Ticagrelor and Clopidogrel in Post Percutaneous Transluminal Coronary Angioplasty (PTCA) Patients Approaching A Tertiary Care Hospital in South IndiaParvathy Krishnan, Sharmila Mohan, Doyce Jom, Roji Jacob, Siby Joseph, Rajesh Thachathodiyl, Vikrant Vijan.
Introduction: Dual antiplatelet therapy is recommended for prevention of secondary cardiovascular events in acute
coronary syndrome patients who undergo percutaneous transluminal coronary angioplasty (PTCA). This therapy includes
aspirin with either of a P2Y12 platelet receptor inhibitor like clopidogrel or ticagrelor. Methodology: A retrospective cohort
study with 1 year follow up which compared clopidogrel and ticagrelor for determining clinical effectiveness in post PTCA
patients through the incidence of primary and secondary end points. Primary end points included cardiovascular death,
Myocardial Infarction (MI), unstable angina, secondary revascularization and Congestive Heart Failure (CHF). Secondary
end points were bleeding and dyspnea. Results: Age, gender, cardiovascular risk factors, concomitant medications
administered and angioplasty specifications like the number of stents, type of stents and approach route were in comparable
between clopidogrel and ticagrelor groups. The primary end points, a composite of cardiovascular death, unstable
angina and secondary revascularization occurred more in the clopidogrel group (9%) than in ticagrelor group (5%) in
12 months follow up period. The secondary end points, a composite of bleeding and dyspnea were observed more in the
ticagrelor group (11%) compared to clopidogrel group (5%). Conclusion: The use of ticagrelor prevents the incidence of
secondary cardiovascular events in post PTCA patients to a greater degree than clopidogrel in comparable risk groups.
Our observation revealed that ticagrelor was found to be better drug than clopidogrel as a prophylactic antiplatelet drug
though there was increased incidence of dyspnea and bleeding in ticagrelor group.
Antiplatelets, Ticagrelor, Clopidogrel.
Archives of Clinical and Experimental Surgery (ACES)
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