Evaluation of efficacy and safety of antiplatelet combinations [Clopidogrel plus Aspirin versus Ticagrelor plus Aspirin] in patient with the thromobotic cardiovascular diseases – An observational study

Abstract

Background: Patients surviving an acute coronary syndrome (ACS) remain at increased risk of ischemic events long term. To test the hypothesis that ticagrelor plus aspirin is safe and superior to clopidogrel plus aspirin for reducing thromobotic cardiovascular diseases and stroke recurrence in Indian patients study was done. Methodology: A prospective, observational clinical study was carried out in the Department of General Medicine, of a tertiary care teaching hospital, Haldia, West Bengal. Permission from the Institutional Ethics Committee was obtained before starting research work. Subjects and their accompanying family members was interviewed by pre-structured questionnaire, and past and present prescriptions and case notes, where available, was captured and reviewed. Results: A total of 80 patients with CAD were enrolled for the study and equally divided in two groups to see efficacy and safety of dual antiplatelet therapy. The median age was 53.08 years in group 1 and 51.67 years in group 2; 17.5 percent and 22.5% of the patients were women in group 1 and group 2 respectively. Majority of the participants were male in both the groups [group 1 (82.5%) & group 2 (77.5%)]. The rate of the primary safety end point (severe bleeding according to the GUSTO definition) was 2.5% in the clopidogrel plus group 1 and 5% in group 2. The rate of moderate bleeding was 2.5% percent in the ticagrelor group and clopidogrel plus aspirin group. The total rate of intracranial hemorrhage was mild 7.5%, moderate 2.5% and severe 2.5% in the two treatment groups respectively. Conclusion: The availability of new antiplatelet agents and extended or combination therapy has increased the options for secondary prevention among ACS patients.