ISSN: 2149-2247 | E-ISSN: 2149-2549
Erciyes Medical Journal Efficacy and Safety of Switching from Clopidogrel to Ticagrelor at the Time of Discharge in STEMI Patients Treated with a Pharmacoinvasive Approach [Erciyes Med J]
Erciyes Med J. 2021; 43(4): 373-378 | DOI: 10.14744/etd.2020.25478

Efficacy and Safety of Switching from Clopidogrel to Ticagrelor at the Time of Discharge in STEMI Patients Treated with a Pharmacoinvasive Approach

Ali Çoner1, İbrahim Haldun Müderrisoğlu2
1Departments of Cardiology, Başkent University Hospital Alanya Application and Research Center, Antalya, Turkey
2Departments of Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey

Objective: The aim of the study was to search for the efficacy and safety of switching from clopidogrel to ticagrelor at the time of discharge in ST-segment elevation myocardial infarction (STEMI) patients treated with a pharmacoinvasive approach.
Materials and Methods: STEMI patients who were managed with pharmacoinvasive approach were involved in the study population. Patients were divided into two groups as clopidogrel and ticagrelor depending on the choice of P2Y12 inhibitor at the time of discharge. All-cause mortality, stent thrombosis, recurrent myocardial infarction, need for target lesion revascularization, and any major bleeding (BARC classification ≥2) were defined as composite clinical end points at the end of the 12th month follow-up.
Results: A total of 194 patients (male: 156 patients, 80.4%; mean age 60.2±11.5 years) were involved in the study population (130 clopidogrel and 64 ticagrelor patients). The median time interval for switching time to ticagrelor was 48 (48–72) h. In a subgroup analysis for patients with a stented segment ≥30 mm, discharge with clopidogrel was related to 6.9 times increase in composite end points compared to patients discharged with ticagrelor (odds ratio: 6.955, confidence interval 95%: 1.512–30.980, p=0.012).
Conclusion: Switching from clopidogrel to ticagrelor at the 48th h following fibrinolytic administration had similar safety end points in STEMI patients managed with pharmacoinvasive approach. In a subgroup of study patients with a total stent length of ≥30 mm, switching to ticagrelor was found to be superior to clopidogrel regarding composite clinical end points.

Keywords: Clopidogrel, dual antiplatelet therapy, pharmacoinvasive approach, ST-segment elevation myocardial infarction, ticagrelor.

Ali Çoner, İbrahim Haldun Müderrisoğlu. Efficacy and Safety of Switching from Clopidogrel to Ticagrelor at the Time of Discharge in STEMI Patients Treated with a Pharmacoinvasive Approach. Erciyes Med J. 2021; 43(4): 373-378

Corresponding Author: Ali Çoner, Türkiye
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