Research on different ticagrelor dosage in elderly patients undergoing percutaneous coronary intervention / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate ADP-induced platelet aggregation rate(ADP-Ag),safety and efficacy of different ticagrelor dosage in elderly patients undergoing PCI. Methods 48 elderly patients aged 60 or older were enrolled. After PCI treatment, the patients received antiplatelet therapy with ticagrelor 90 mg(n=26)or 45 mg (n=22)twice daily. ADP-Ag was measured on day 3 to 7 after initial ticagrelor therapy and compared between the two different-dose ticagrelor groups. ADP-Ag ticagrelor treatment was also compared to measurement if patients were previously taking clopidogrel 75 mg daily. Major adverse cardiovascular events (MACE)and bleeding events were recorded in following 12 months. Results Inhibition of ADP-induced platelet aggregation was greater for ticagrelor 90 mg BID versus 45 mg BID(ADP-Ag(27.88±7.77)% vs.(37.87±2.90)%,P<0.05). During the follow-up period,no gastrointestinal bleedings,cerebral hemorrhage or thrombus events occurred in all patients. In ticagrelor 90 mg BID group,stent-restenosis occurred in 3 patients and they needed to take revascularization therapy. Minimal bleeding events occurred in 4 patients(15.4%)and 1 patient(4.5%) with ticagrelor 90 mg and 45 mg BID treatment,respectively. The ADP-Ag with clopidogrel 75 mg QD treatment previously was(51.18±5.55)%,and declined to(26.87±7.33)% and(38.29±2.65)% after conversion to ticagrelor 90 mg BID and 45 mg BID treatment,respectively. Conclusions Ticagrelor of 90 mg BID or 45 mg BID both inhibited ADP-induced platelet aggregation better than clopidogrel. Ticagrelor 45 mg BID was not inferior to 90 mg BID in preventing MACE and with less minimal bleeding events in elderly patients undergoing PCI.