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Ticagrelor Versus Clopidogrel in Patients with Late or Very Late Stent Thrombosis

Jinying Zhou1, Yu Tan1,2, Chen Liu1

  • 1Department of Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Cardiovascular Drugs and Therapy
|June 24, 2020
PubMed

Insights

Ticagrelor reduced major adverse cardiovascular events (MACE) in patients with late or very late stent thrombosis (LST/VLST) after percutaneous coronary intervention (PCI). This suggests ticagrelor is more effective than clopidogrel for these high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Late or very late stent thrombosis (LST/VLST) is a serious complication after percutaneous coronary intervention (PCI).
  • Optimal antiplatelet therapy for patients with LST/VLST remains an important clinical question.

Purpose of the Study:

  • To compare the efficacy of ticagrelor versus clopidogrel in preventing ischemic cardiovascular events in patients with LST/VLST post-primary PCI.

Main Methods:

  • A cohort of 241 patients with LST/VLST after primary PCI were analyzed.
  • Patients were grouped based on receiving ticagrelor (n=81) or clopidogrel (n=160) at discharge.
  • Propensity score matching created 65 pairs for comparison of 1-year major adverse cardiovascular events (MACE).

Main Results:

  • The incidence of MACE was significantly lower in the ticagrelor group (9.3%) compared to the clopidogrel group (21.5%) (p=0.048).
  • No significant differences were found in individual components of MACE, including death, myocardial infarction, ischemic stroke, or revascularization.

Conclusions:

  • Ticagrelor use was associated with a significant reduction in MACE in patients with LST/VLST after primary PCI compared to clopidogrel.
  • These findings support the use of ticagrelor in managing patients with LST/VLST to improve clinical outcomes.
Abstract

Keywords:
Antiplatelet therapyClopidogrelStent thrombosisTicagrelor

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