OBJECTIVES:

Embellished anti-platelet activity and therapeutic efficacy is found with Ticagrelor in Acute Coronary Syndrome (ACS)patients than Clopidogrel for preventing major adverse cardiovascular events like Instent Thrombosis and Recurrent Myocardial Infarction. The objective is to investigate the superiority of Ticagrelor over Clopidogrel in prevention of vascular events and death in ACS patients.

METHODS: A randomized single-center observational clinical study was carried out for one year in ACS patients’above18 years who underwent Percutaneous Coronary Intervention.

RESULTS:

Amongst 363 patients randomised, 43% received 180 mg Ticagrelor as loading dose and 90 mg thereafter. While 57% were administered with 300-600 mg Clopidogrel as a loading dose followed by 75 mg maintenance dose. The utilization of both Ticagrelor(56%) and Clopidogrel(68.2%) were found high in geriatric population (51-70 years). The primary endpoint(death)revealed 5% death rate with Ticagrelor and 8% (p=0.368) with Clopidogrel. The secondary endpoints like stroke and myocardial infarction were 4.5% with Ticagrelor and 6.8% with Clopidogrel also, the incidence of In-stent thrombosis was found to be 0.6% with the former and 2% with the latter drug.

CONCLUSIONS:

Despite the increase in death rates with Clopidogrel compared to Ticagrelor, supportive outcomes cannot be drawn from this study due to minimal discrepancy in secondary endpoints, which insists for an upgraded research with a higher sample size.