Comparative Safety and Effectiveness of Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndrome: An On-Treatment Analysis from a Multicentre Registry

Observational studies that failed to take time-dependent confounders into account have lately called into doubt the net therapeutic advantage of ticagrelor over clopidogrel in acute coronary syndrome (ACS). The authors aimed to evaluate the comparative safety and efficacy of ticagrelor vs. clopidogrel in real-life setting by taking into account the non-adherence of the therapy. The following are key points to remember from this prospective, multi-cohort study on the outcomes in ACS patients discharged on ticagrelor or clopidogrel: Out of a total of 2070 patients, 1,035 patients were discharged on ticagrelor and clopidogrel, respectively. When compared to clopidogrel users, patients on ticagrelor were younger and had fewer comorbidities, but had higher rates of drug non-compliance. In comparison to clopidogrel, ticagrelor did not increase the risk of severe bleeding after extensive multivariate adjustments. In comparison to clopidogrel, Ticagrelor resulted in clinical net benefit by showing a superiority in reduction of MACE events, vascular death, and definite probable stent thrombosis. The results of the sensitive analysis and primary analysis were consistent whereas results from the intention intention-to-treat (ITT) analysis were found in the opposite direction. When compared to clopidogrel, ticagrelor produced a net therapeutic benefit among all-comers with ACS while not significantly raising the risk of severe haemorrhage. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.