Date of Award
Open Access Thesis
MS in Physician Assistant Studies (PA)
Physician Assistant Studies
Kurt DeVine, MD
Background: Dual antiplatelet therapy (DAPT) is an effective secondary prevention and an essential component of treatment after patients suffering from acute coronary syndrome (ACS). Recently, clinicians rapidly switched to DAPT with ticagrelor as the preferred treatment option after it was introduced in 2011. Compared to clopidogrel, ticagrelor is not a prodrug and does not require metabolic activation to inhibit the platelet P2Y12 receptor. It is the first reversible oral P2Y12 receptor antagonist; and its effect on platelet inhibition is more pronounced compared to clopidogrel.
Purpose: The purpose of this comprehensive review was to evaluate the efficacy and safety data of ticagrelor when compared with clopidogrel in ACS patients.
Methods: A comprehensive literature review was conducted using Tripdatabases and Pubmed search engines was searched through June 2022 using the terms: “dual antiplatelet therapy,” “antiplatelet monotherapy,” “ticagrelor vs clopidogrel,” “reduce recurrent atherothrombotic events,” “cardiovascular adverse events,” “coronary heart disease,” “acute coronary syndrome,” “myocardial infarction.” Inclusion criteria were recently published studies (at least 15 studies within the last five years from the day this review was performed) comparing the efficacy of ticagrelor with clopidogrel or placebo. The type of trials could be retrospective studies or prospective randomized controlled studies with complete data and reportable clinical outcomes. Exclusion criteria were case reports, repeated publications, animal experiments, and studies that were poorly designed with errors, incomplete data, or without clinical outcomes.
Conclusions: Through the literature review from many blinded, randomized controlled trials and studies, ticagrelor has successfully shown its superior efficacy in reducing the rate of cardiovascular adverse events in ACS patients and shown no significant difference in the rate of major bleeding between ticagrelor and clopidogrel.
Vu, Binh, "Dual Antiplatelet Therapy With Ticagrelor vs Clopidogrel in Patients With Acute Coronary Syndrome" (2022). Theses and Graduate Projects. 1236.