Ticagrelor vs. Clopidogrel in Real-Life Patients with Acute Coronary Syndromes: Another View

In contrast to an older, large, randomized trial, net adverse clinical events with the two drugs did not differ in this observational matched cohort study.

Current guidelines recommend aspirin and ticagrelor over clopidogrel for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), based on the >18,000-patient, randomized PLATO trial (NEJM JW Cardiol Nov 2009 and N Engl J Med 2009; 361:1045). However, adverse effects with ticagrelor, including bleeding, have prompted additional comparisons, including this study using U.S. and South Korean electronic health records and an administrative database on 183,579 patients undergoing PCI after ACS between 2011 and 2019.

The researchers performed propensity-score matching, which yielded 31,290 matched pairs of ticagrelor and clopidogrel recipients. During 1 year of follow-up, the risk for net adverse clinical ev…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)