Comparisons of clinical outcomes among ACS patients receiving ticagrelor versus clopidogrel at Maharaj Nakorn Chiang Mai Hospital: a retrospective cohort study
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Abstract
This research has the objective to evaluate clinical outcomes in terms of effectiveness and safety of using ticagrelor compared with clopidogrel for 1 year among acute coronary syndrome patients. Method: A retrospective cohort study was conducted among patients with acute coronary syndrome received ticagrlor or clopidogrel together with aspirin, admitted at Maharaj Nakorn Chiang Mai Hospital between 1 January 2017 and 31 December 2017. Data of patients were collected from medical records of patients admitted at Maharaj Nakorn Chiang Mai Hospital. Results: A total of 205 patients’ fullfiled with inclusion criteria were included in the analysis: 99 patients (21 women, mean age 63.9 10.5 years) used ticagrelor and 106 patients (38 women, mean age 66.8 11.9 years) used clopidogrel. The primary efficacy endpoint, a composite outcome of major adverse cardiovascular outcome (MACE) including cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, occurred in 2 patients: 1 in patient used ticagrelor and 1 in clopidogrel. For the primary safety endpoints (bleeding and dyspnea), patients used ticagrelor and clopidogrel did not differ in bleedings, 10 patients in ticagrelor and 7 clopidogrel, p-value=0.450, but ticagrelor group was associated with a higher rate of dyspnea significantly (10.0% and 2.0% respectively, p-value 0.016). Conclusion: Among patients with acute coronary syndrome treated with ticagrelor or clopidogrel for 1 year follow-up, the two groups did not differ in MACE and safety outcome of bleeding, but their safety outcome of dyspnea was higher in those used ticagrelor than those used clopidogrel that should be pay more attention.
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