Effects of Ticagrelor Versus Clopidogrel in Patients with Coronary Bifurcation Lesions Undergoing Percutaneous Coronary Intervention

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2019 Apr 25

PMID 31016189

Citations 6

Authors

Wei Zheng

Youmei Li

Jingdu Tian

Lufeng Li

Li Xie

Qi Mao

Wuyang Tong

Denglu Zhou

Lorenzo Azzalini

Xiaohui Zhao

Affiliations

Soon will be listed here.

Abstract

Background: Percutaneous treatment of coronary bifurcation lesions can potentially lead to higher risk of ischemic events than the nonbifurcation ones, thus calling for further optimization of dual antiplatelet therapy (DAPT). This study aimed to compare the clinical outcomes from ticagrelor and clopidogrel in bifurcation lesions patients undergoing percutaneous coronary intervention (PCI).

Methods: We performed a retrospective cohort study in patients with coronary bifurcation lesions. A total of 553 patients discharged on ticagrelor or clopidogrel combined with aspirin were recruited for 1-year follow-up. The incidences of primary endpoint (major adverse cardiovascular event [MACE]: a composite of cardiac death, myocardial infarction [MI] or stroke), secondary endpoints (the individual component of the primary endpoint or definite/probable stent thrombosis), and major bleeding (Bleeding Academic Research Consortium [BARC]≥3 bleeding events) were evaluated. To minimize the selection bias, a propensity score-matched population analysis was also conducted.

Results: The risks of both primary endpoint (8.15% and 12.01% for the ticagrelor and clopidogrel groups, respectively; adjusted hazards ratio [HR]: 0.488, 95% confidence interval [CI]: 0.277-0.861, P=0.013) and MI (4.44% and 8.48% for the ticagrelor and clopidogrel groups, respectively; adjusted HR: 0.341, 95% CI: 0.162-0.719, P=0.005) were significantly reduced in the ticagrelor group as compared with those of the clopidogrel counterpart, whereas the risk of major bleeding was comparable (2.96% and 2.47% for the ticagrelor and clopidogrel groups, respectively; adjusted HR: 0.972, 95% CI: 0.321-2.941, P=0.960). Propensity score-matched analysis confirmed such findings.

Conclusions: For patients with bifurcation lesions after PCI, ticagrelor treatment shows lower MACE and MI rates than the clopidogrel one, along with comparable major bleeding.

Citing Articles

Left Main Disease and Bifurcation Percutaneous Coronary Intervention: Focus on Antithrombotic Therapy.

Varlamos C, Lianos I, Benetou D, Alexopoulos D US Cardiol. 2024; 15:e11.

PMID: 39720505 PMC: 11664771. DOI: 10.15420/usc.2020.34.

Comparison of clopidogrel and ticagrelor in treating acute coronary syndrome undergoing PCI: A systematic review and meta-analysis.

Yang J, Zhang R, Liu Q, Bai Y, Zhang L, He T Heliyon. 2024; 10(5):e26553.

PMID: 38455558 PMC: 10918014. DOI: 10.1016/j.heliyon.2024.e26553.

Influence of early dose reduction of ticagrelor on clinical outcomes following percutaneous coronary intervention for complex lesions.

Lee Y, Shin J, Seo S, Choi I, Lee J, Lee J Sci Rep. 2023; 13(1):15481.

PMID: 37726368 PMC: 10509174. DOI: 10.1038/s41598-023-42655-4.

[The value of cytochrome P4502C19 gene assay for anti-platelet therapy after PCI in stable angina patients with left main coronary artery lesions].

Zheng X, Wu L Nan Fang Yi Ke Da Xue Xue Bao. 2020; 40(2):274-278.

PMID: 32376540 PMC: 7086122. DOI: 10.12122/j.issn.1673-4254.2020.02.21.

An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study.

Yurtdas M, Asoglu R, Ozdemir M, Asoglu E Medicina (Kaunas). 2020; 56(3).

PMID: 32121323 PMC: 7143646. DOI: 10.3390/medicina56030102.

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