Ticagrelor versus clopidogrel in Chinese patients with coronary artery disease: a retrospective real-world study

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Dual antiplatelet therapy (DAPT) is crucial for patients with coronary artery disease (CAD).
• Ticagrelor and clopidogrel are commonly used P2Y12 inhibitors in DAPT regimens.
• Comparative effectiveness and safety data in specific populations, like Chinese CAD patients, are essential.

Purpose of the Study:

• To compare the efficacy and safety of ticagrelor versus clopidogrel in Chinese patients with CAD undergoing DAPT.
• To evaluate the incidence of major adverse cardiovascular events (MACE) and bleeding risk between the two treatment groups.

Main Methods:

• A retrospective study conducted at the Chinese PLA General Hospital involving 844 patients on DAPT.
• Patients were divided into aspirin + clopidogrel (A+C) and aspirin + ticagrelor (A+T) groups.
• Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for confounders, followed by Cox regression analysis.

Main Results:

• No significant differences were observed in MACE or Bleeding Academic Research Consortium (BARC) type 3/5 bleeding between the A+C and A+T groups.
• The A+T group demonstrated a significantly higher risk of BARC type 2 bleeding (HR: 4.16, 95% CI: 2.18-7.90).
• MACE incidence rates were 2.38% in A+C and 3.29% in A+T.

Conclusions:

• Ticagrelor and clopidogrel exhibit similar efficacy in preventing MACE and severe bleeding (BARC type 3/5) in Chinese CAD patients.
• Ticagrelor use is associated with an increased risk of minor bleeding (BARC type 2) compared to clopidogrel.