Cardiology
November 23, 2020
Ticagrelor vs Clopidogrel in Elective PCI
The Lancet
TAKE-HOME MESSAGE
This multicenter, open-label phase III study conducted in France and the Czech Republic compared outcomes in 1910 patients with stable coronary artery disease, at least one high-risk characteristic, and an indication for percutaneous coronary intervention (PCI).
The participants were randomized to receive ticagrelor or clopidogrel after PCI.
Based on an intention-to-treat analysis, there were no significant differences in the primary outcome, which was a composite of PCI-related type 4 myocardial infarction or major myocardial injury, or the primary safety outcome of major bleeding.
These outcomes were evaluated within 48 hours of PCI or at hospital discharge, whichever was earlier. However, minor bleeding events at 30 days was higher in the ticagrelor than in the clopidogrel group.
These results showed that ticagrelor did not improve outcomes after elective PCI and did increase minor bleeding, so the authors recommend that clopidogrel should remain the standard of care following elective PCI.