Ticagrelor as Compared to Clopidogrel Following Percutaneous Coronary Intervention for Acute Coronary Syndrome
Section snippets
Methods
Adult patients with a diagnosis of ACS who underwent PCI between the study dates of January 1, 2015 and March 31, 2020 were identified from the Manitoba Center for Health Policy database. ACS included ST-elevation MI, non-ST-elevation MI, and unstable angina. The Manitoba Center for Health Policy database is a central registry that includes the vital statistics and diagnostic codes for all healthcare system contacts within the province of Manitoba, Canada. Data obtained included demographic
Results
A total of 13,128 PCI procedures were performed during the study period. Of these, there were 7,610 unique patients who underwent PCI for the indication of ACS; 945 of these were excluded, predominantly for the reason of being on an anticoagulant or P2Y12i at baseline. Of the remaining 6,665 patients, 2,108 were prescribed clopidogrel, 4,214 were prescribed ticagrelor, and 343 did not fill a prescription for either within 30 days of discharge from the index admission (Figure 1).
The baseline
Discussion
Since the publication of PLATO, major society guidelines have suggested a preference for higher-potency P2Y12i over clopidogrel in patients with ACS.8,9 In accordance to the guidelines, the frequency of ticagrelor prescription increased over the course of the study period. In this study, significantly reduced MACE, stroke, and all-cause hospitalization and a numeric trend toward reduced all-cause mortality was observed among patients who were prescribed ticagrelor compared with clopidogrel
Disclosures
The authors have no conflicts of interest to declare.
References (15)
- et al.
Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (Popular AGE): the randomised, open-label, non-inferiority trial
Lancet
(2020) - et al.
Effects of ticagrelor versus clopidogrel on platelet function in fibrinolytic-treated STEMI patients undergoing early PCI
Am Heart J
(2017) - et al.
Randomized trials versus common sense and clinical observation: JACC review topic of the week
J Am Coll Cardiol
(2020) - et al.
Ticagrelor vs prasugrel in a contemporary real-world cohort undergoing percutaneous coronary intervention
JACC Cardiovasc Interv
(2022) - et al.
Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation
N Engl J Med
(2001) - et al.
Ticagrelor versus clopidogrel in patients with acute coronary syndromes
N Engl J Med
(2009) - et al.
Association of Ticagrelor vs Clopidogrel with major adverse coronary events in patients with acute coronary syndrome undergoing percutaneous coronary intervention
JAMA Intern Med
(2020)
Cited by (0)
This work was supported through funding provided by the Department of Health of the Province of Manitoba to the University of Manitoba, Winnipeg, Manitoba, Canada, HIPC/PHRPCNo. 2018/2019-67. Data used in this study are from the Population Health Research Data Repository housed at the Manitoba Center for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health, Seniors, and Active Living, Vital Statistics, and Shared Health Diagnostic services.