Abstract:
AIM To explore the efficacy and safety of ticagrelor and clopidogrel in the treatment of acute coronary ayndrome (ACS) in Chinese elderly patients without revascularization.
METHODS Continuously enrolled for this study were 106 Chinese elderly ACS patients (≥75 years old) who were not treated with interventional therapy in our department from May 2012 to September 2020. According to antiplatelet drugs, the enrolled patients were divided into clopidogrel group (n=65) and ticagrelor group (n=41) and the follow-up was 12 months. The effective end point was the major adverse cardiovascular event (MACE), which was composed of all-cause death, nonfatal myocardial infarction and clinically-driven revascularization. The safety endpoint is BARC bleeding event.
RESULTS There were more patients with chronic kidney disease in the clopidogrel group (P<0.05) and there was no significant difference between the two groups in baseline data such as basic data, past medical history and laboratory data. The incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (4.9% vs. 18.5%) and the difference was statistically significant (P<0.05). The incidence of bleeding events in the ticagrelor group was higher than that in the clopidogrel group (7.3% vs. 3.1%) and the difference was not statistically significant.
CONCLUSION Compared with clopidogrel, ticagrelor reduces the incidence of MACE in elderly ACS patients without interventional therapy, and it does not significantly increase bleeding events.