One-quarter standard-dose ticagrelor better than standard-dose clopidogrel in Chinese patients with stable coronary artery disease: A randomized, single-blind, crossover clinical study

BackgroundTicagrelor has been demonstrated to provide a more rapid and powerful inhibition of platelet aggregation compared with clopidogrel in coronary artery disease (CAD) patients. In our previous study, we found that half-dose ticagrelor produced similar inhibitory effects on platelet aggregation as standard-dose ticagrelor and exerted significantly stronger effects than clopidogrel in Chinese patients with non-ST-elevation ACS. Therefore, we performed this study to observe the efficacy of one-quarter standard-dose ticagrelor in comparison to standard-dose clopidogrel in Chinese patients with stable CAD.MethodsIn a randomized, single-blind, crossover trial, 30 patients with stable CAD were randomized to one-quarter standard-dose ticagrelor (22.5 mg BID for 7 days) or standard-dose clopidogrel (75 mg QD for 7 days). Following a 2-week washout period, patients switched regimens. Light transmission aggregometry (LTA) and VerifyNow assay were used to measure platelet function.ResultsThe platelet aggregation rate (PAgR) was obviously lower with ticagrelor than clopidogrel (17.70% ± 12.67% versus 27.63% ± 13.10%, P < 0.05). The % inhibition levels in the ticagrelor group exhibited significantly greater than that in the clopidogrel group (65.33% ± 21.31% versus 36.23% ± 23.01%, P < 0.01). PRU values in the ticagrelor group were dramatically lower than that in the clopidogrel group (87.03 ± 51.38 versus 163.77 ± 58.66, P < 0.01). High-platelet reactivity (HPR) (≥ 208 PRU) was 0% with ticagrelor and 16.67% with clopidogrel.ConclusionsOne-quarter standard-dose ticagrelor provided greater degree of platelet inhibition than standard-dose clopidogrel in Chinese patients with stable CAD.