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Ticagrelor vs clopidogrel in patients with acute coronary syndrome undergoing complex percutaneous coronary intervention

Catheterization and Cardiovascular InterventionsLi Y, Li J, Qiu M, et al. | January 18, 2022


In acute coronary syndrome (ACS) patients undergoing complex percutaneous coronary intervention (PCI), a significantly lower risk of ischemic events was noted in relation to treatment with ticagrelor compared with clopidogrel, while the risk of major bleeding was comparable between the two drugs.

  • An all-comers PCI registry was used to assess the effectiveness as well as safety of ticagrelor vs clopidogrel in patients with ACS undergoing complex PCI.

  • Of participants, 4,373 (35.2%) and 8065 (64.8%) had dual antiplatelet therapy based on ticagrelor and clopidogrel, respectively.

  • In the ticagrelor-treated group, significantly lower incidences of composite ischemic events (before propensity score matching [PSM]: 1.74% vs 2.84%; after PSM: 1.50% vs 2.65%) and all-cause death (before PSM: 1.23% vs 2.12%; after PSM: 1.09% vs 1.81%) were reported, compared to the clopidogrel-treated group.

  • No significant difference in Bleeding Academic Research Consortium types 2, 3, and 5 bleeding was found between groups.