COMPARATIVE STUDY ON BLEEDING COMPLICATION OF CLOPIDOGREL VERSUS TICAGRELOR IN PATIENTS WITH ACUTE CORONARY SYNDROME

Background: In the Platelet Inhibition and Patient Outcome (PLATO) trial, ticagrelor compared with clopidogrel reduced the primary composite end point of death from vascular causes, myocardial infarction or stroke after ACS, but increase the risk of bleeding complications. Objective: To evaluate the safety outcome in patients on clopidogrel and ticagrelor, to assess the severity of bleeding based on TIMI and CRUSADE score and to determine the impact of bleeding complications on mortality. Methods and Results: In this prospective observational study, we studied 200 acute coronary syndrome patients with co-morbidities. The primary end point was occurrence of any type of bleeding, and is determined as per international bleeding criteria’s TIMI and CRUSADE. Both clopidogrel and ticagrelor induced bleeding cases were reported. The incidence of overall bleeding was higher in patients taking ticagrelor compared to those taking clopidogrel in patients with acute coronary syndrome. Conclusion: In patients with acute coronary syndrome with or without ST segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduce the rate of death from vascular causes, myocardial infarction or stroke without an increase in the rate of overall major bleeding but with an increase in the rate of non- procedure related bleeding. Keywords: Acute coronary syndrome, ST elevated myocardial infarction, Non-ST elevated myocardial infarction, Clopidogrel, Ticagrelor