P2Y12 Inhibition in Patients Requiring Oral Anticoagulation After Percutaneous Coronary Intervention: The SWAP-AC-2 Study
Authors' conclusion
In NOAC-treated patients undergoing PCI with an ABCD-GENE score ≥10, ticagrelor-based DAT using a 60-mg, twice-a-day regimen reduced platelet P2Y12 reactivity compared with clopidogrel-based DAT.
Study context
- Population
- Novel oral anticoagulant (NOAC)-treated patients undergoing percutaneous coronary intervention (PCI); randomised: ABCD-GENE score ≥10 (impaired clopidogrel response)39 randomised
- Participants
- 20 / 19 / 42
- Comparison
- Ticagrelor vs Clopidogrel
- Ticagrelorn = 20
- Clopidogreln = 19reference
- Controln = 42
- Primary endpoint
- PRU (trough levels)
- Follow-up
- 30 days
Methodological detailsprospective, pharmacodynamic study
- Prospective
- Pharmacodynamic study
Primary result
As reported in the abstract
Trough PRU
Ticagrelor
23.0
IQR 3.0–46.0
Clopidogrel
154.5
IQR 77.5–183.0
P < 0.001
Further findings
| Outcome | Ticagrelor | Clopidogrel | Control | P value | |
|---|---|---|---|---|---|
| Peak PRU · 30 days | 6.0 (IQR 4.0–14.0) | 129.0 (IQR 66.0–171.0) | Not reported in the abstract | P < 0.001 | Control: not reported in the abstract |
| Trough PRU, control cohort · 30 days — Control vs Ticagrelor · higher in control | Not reported in the abstract | Not reported in the abstract | 104.0 (IQR 35.0–167.0) | P = 0.005 | Ticagrelor, Clopidogrel: not reported in the abstract |
| Trough PRU, control cohort · 30 days — Control vs Clopidogrel · numerically lower in control | P = 0.234 |
Light transmittance aggregometry and VASP
- Results consistent with PRU
Markers of non-P2Y12 thrombosis pathways
- Largely unaffected
Original publication
P2Y12 Inhibition in Patients Requiring Oral Anticoagulation After Percutaneous Coronary Intervention: The SWAP-AC-2 Study. JACC Cardiovasc Interv. Published 7 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it