Ticagrelor Versus Clopidogrel in Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention for Acute Coronary Syndrome in Chronic Kidney Disease
Document Type
Conference Proceeding
Publication Date
5-2025
Publication Title
Journal of the Society for Cardiovascular Angiography and Interventions
Abstract
Background: Dual antiplatelet therapy (DAPT) is the standard treatment post percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Although ticagrelor and clopidogrel are commonly used, data on their efficacy in chronic kidney disease (CKD) patients is scarce. We aimed to examine the outcomes of ticagrelor versus clopidogrel as DAPT in CKD patients using a multi-national data set. Methods: Using the TriNetX Analytics Research Network, our study included patients aged 18 with CKD and ACS post-PCI between 1/1/2004 and 1/1/2024. Patients were grouped into ticagrelor and aspirin versus clopidogrel and aspirin group. Outcomes included acute myocardial infarction (AMI), all-cause mortality, hospitalization, cerebrovascular accident (CVA), and major bleeding over 1-year follow-up. Results: A total of 18,579 patients were identified, including 2130 (11.5%) patients receiving ticagrelor and aspirin. After propensity-score matching, 2102 cohorts receiving ticagrelor and aspirin (68.9 11.8 years, 32.7% female, 12.8% African American) versus clopidogrel and aspirin (69.0 12.3 years, 31.6% female, 13.1% African American) were analyzed. The risks of AMI [odds ratio (OR): 0.912, 95% confidence interval (CI): 0.808-1.030], all-cause mortality (OR: 1.049, 95% CI: 0.892-1.235), and hospitalization (OR: 1.005, 95% CI: 0.871-1.161) were similar between both groups. However, ticagrelor group had a lower risk of CVA (OR: 0.624, 95% CI: 0.493-0.788) and major bleeding (OR: 0.804, 95% CI: 0.649-0.995) compared to clopidogrel group. Conclusions: Ticagrelor use in ACS with CKD patients lowers CVA and major bleeding risk compared to clopidogrel.
Volume
4
Issue
5 Suppl
First Page
23
Last Page
24
Recommended Citation
Winson T, Vignarajah A, Tan MC, Yeo YH, Ang QX, Lee JZ. Ticagrelor versus clopidogrel in dual antiplatelet therapy following percutaneous coronary intervention for acute coronary syndrome in chronic kidney disease. J Soc Cardiovasc Angiogr Interv. 2025 May;4(5 Suppl):23-24. doi: 10.1016/j.jscai.2025.103179
DOI
10.1016/j.jscai.2025.103179
Comments
Society for Cardiovascular Angiography and Interventions SCAI 48th Annual Scientific Sessions, May 1-3, 2025, Washington, DC