THE COMPARISON OF EFFICACY AND SAFETY OF TICAGRELOR VERSUS CLOPIDOGREL IN THE MANAGEMENT OF ACUTE CORONARY SYNDROME: A SYSTEMATIC REVIEW

Dual antiplatelet therapy (DAPT) forms the main pillar of the medical management of acute coronary syndrome (ACS). Historically clopidogrel has been in use as part of DAPT but recent evidence has shown that it has a slow onset of action and less potent antiplatelet efficacy which has lead to cases of myocardial infarction and stent thrombosis. As a consequence, it has lead to the development of newer P2Y12 receptor antagonists like ticagrelor and prasugrel. Ticagrelor has a rapid onset of action and more potent platelet inhibition quality which has resulted in better cardiovascular outcomes in patients of ACS. We have conducted a systematic review to retrieve clinical evidence regarding the efficacy and safety profile of ticagrelor versus clopidogrel and it has shown that ticagrelor has demonstrated superiority in terms of its efficacy and safety profile as compared to clopidogrel. Such an analysis has got great clinical implications on the future of management of ACS patients as stent thrombosis and myocardial infarction, which occurs due to inadequate platelet inhibition, form the major morbidity and mortality in patients experiencing an episode of ACS. Hence the choice of a drug that has got potent antiplatelet activity, not at the expense of major bleeding, will drastically improve the prognosis of ACS patients.

Keywords: Ticagrelor, Clopidogrel. Acute Coronary Syndrome, Bleeding, Efficacy, Cardiovascular outcomes