Ticagrelor vs Clopidogrel in Clopidogrel-Naive Patients With Chronic Coronary Syndrome

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43927095" target="_blank" >RIV/00064173:_____/24:43927095 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/24:43927095 RIV/00216208:11130/24:10481084

Result on the web

<a href="https://doi.org/10.1016/j.jcin.2024.04.015" target="_blank" >https://doi.org/10.1016/j.jcin.2024.04.015</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jcin.2024.04.015" target="_blank" >10.1016/j.jcin.2024.04.015</a>

Result language

angličtina

Original language name

Ticagrelor vs Clopidogrel in Clopidogrel-Naive Patients With Chronic Coronary Syndrome

Original language description

BACKGROUND Whether ticagrelor may reduce periprocedural myocardial necrosis after elective percutaneous coronary intervention (PCI) in patients with and without chronic clopidogrel therapy is unclear. OBJECTIVES This study sought to compare ticagrelor vs clopidogrel in patients with and without chronic clopidogrel therapy before undergoing elective PCI. METHODS In this prespeci fied analysis of the ALPHEUS (Assessment of Loading With the P2Y12 Inhibitor Ticagrelor or Clopidogrel to Halt Ischemic Events in Patients Undergoing Elective Coronary Stenting) trial, patients were de fined as clopidogrel(+) and clopidogrel(-) according to the presence and absence of clopidogrel treatment for $7 days before PCI, respectively. The primary endpoint was the composite of PCI-related myocardial infarction and major injury as de fined by the third and fourth universal de finition 48 hours after PCI. RESULTS A total of 1,882 patients were included, 805 (42.7%) of whom were clopidogrel(+). These patients were older, had more comorbidities, and had more frequent features of complex PCI. The primary endpoint was less frequently present in clopidogrel(-) compared to clopidogrel(+) patients (32.8% vs 40.0%; OR: 0.73; 95% CI: 0.60-0.88), but no signi ficant differences were reported for the risk of death, myocardial infarction, stroke, or transient ischemic attack at 48 hours or 30 days. Ticagrelor did not reduce periprocedural myocardial necrosis or the risk of adverse outcomes, and there was no signi ficant interaction regarding the presence of chronic clopidogrel treatment. CONCLUSIONS Clopidogrel-naive patients presented less periprocedural complications compared to clopidogrel(+) patients, a difference related to a lower risk pro file and less complex PCI. The absence of clopidogrel at baseline did not affect the absence of a difference between ticagrelor and clopidogrel in terms of PCI-related complications supporting the use of clopidogrel as the standard of care in elective PCI in patients with or without chronic clopidogrel treatment.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

JACC: Cardiovascular Interventions

ISSN

1936-8798

e-ISSN

1876-7605

Volume of the periodical

17

Issue of the periodical within the volume

12

Country of publishing house

US - UNITED STATES

Number of pages

9

Pages from-to

1413-1421

UT code for WoS article

001262743300001

EID of the result in the Scopus database

2-s2.0-85195658777