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Whether patients undergoing elective percutaneous coronary intervention (PCI) fare better with ticagrelor than with clopidogrel has been a subject of debate. In the partly industry-funded ALPHEUS trial (NCT02617290), researchers compared ticagrelor with clopidogrel for reducing periprocedural myocardial necrosis in people with stable coronary artery disease who had an indication for PCI and at least one high-risk characteristic.
Investigators recruited patients from 49 hospitals in France and the Czech Republic and randomized them to receive either ticagrelor (a 180-mg pre-PCI loading dose and then 90 mg twice daily for 30 days) or clopidogrel (a pre-PCI loading dose of 300–600 mg and then 75 mg daily for 30 days). The intention-to-treat pop…