Safety and efficacy of Clopidogrel versus Ticagrelor in treating Non-STEMI elderly patients

Document Type : Original Research Papers

Authors

1 Cardiology Departement, Nasr City Health insurance hospital , Cairo , Egypt.

2 Professor of Cardiology Faculty of Medicine-Benha University

3 Assistant Professor of Cardiology Faculty of Medicine- Benha University

4 Lecturer of Cardiology Faculty of Medicine- Benha University

5 Consultant of Cardiology Health Insurance Hospitals

Abstract

Background: Acute coronary syndrome describes a wide range of clinical conditions that are caused by acute myocardial ischemia. A mismatch between myocardial oxygen demand and supply constitutes the fundamental pathology of ACS. An independent risk factor for major adverse events following acute coronary events, age is furthermore, being a significant risk factor for atherosclerotic cardiovascular disease. In order to prevent recurrent thrombotic events in patients with dual antiplatelet therapy non-ST-elevation acute coronary syndrome, comprising a P2Y12 inhibitor and aspirin is critically important. For their demonstrated anti-inflammatory effects in addition to their antithrombotic properties, antiplatelet medications have been utilised to improve clinical outcomes in patients with atherosclerotic cardiovascular diseases. Methodology: The study. The study included 200 elderly patients presenting with NSTEMI. They were categorized into two groups: group 1: 100 NSTEMI patients received clopidogre, and group 2: 100 NSTEMI patients received ticagrelor. Results: Patients who received clopidogrel demonstrated significantly lower minor bleeding (P = 0.011) and overall bleeding (P < 0.001). Additionally, major bleeding was reduced in participants who received clopidogrel than in patients who received ticagrelor but without statistical significance (P = 0.123). Insignificant differences were reported regarding stent thrombosis, stroke, myocardial infarction, CV death, urgent revascularization and transient ischemic attacks. Conclusion: As an alternative to ticagrelor, clopidogrel is beneficial for elderly patients. Without increasing ischemic risk, clopidogrel is associated with a significantly reduced risk of major and minor bleeding.

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