Coronary disease & ACSCohort study
Ticagrelor versus clopidogrel in orally anticoagulated patients with acute coronary syndrome undergoing percutaneous coronary intervention
- cohort study
- SWEDEHEART registry
- multivariate Cox regression
- adjusted hazard ratios
Authors' conclusion
In ACS patients on DOACs undergoing PCI, ticagrelor was associated with an increased risk of bleeding compared with clopidogrel, with no differences in MACE, mortality, or MI.
Study context
- Population
- Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) on dual antithrombotic treatment with direct oral anticoagulants (DOACs), January 2014 to February 2022median age 76 years, 69% males, 40% ST-segment elevation myocardial infarction
- Participants
- 3,708 patients
- Exposure
- ticagrelor versus clopidogrel as part of dual antithrombotic treatment
- ticagrelorn = 1,170
- clopidogreln = 2,538reference
Main finding
Major adverse cardiovascular events (MACE):
· within one year
Adjusted hazard ratio
1.02
95% CI 0.84–1.23
By group
ticagrelor vs clopidogrel
aHR 1.02 (95% CI 0.84–1.23)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | ticagrelor | clopidogrel | aHR (95% CI) | |
|---|---|---|---|---|
| Mortality · within one year | 6.6% | 6.2% | 1.24 (0.91–1.69) | |
| MI · within one year | 10.4% | 11.2% | 0.90 (0.71–1.13) | |
| 0.512Adjusted hazard ratio (log scale) |
Safety
| Outcome | ticagrelor | clopidogrel | aHR (95% CI) | |
|---|---|---|---|---|
| Bleeding (clinically relevant bleeding) · within one year | 4.9% | 3.7% | 1.53 (1.06–2.22) | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Ticagrelor versus clopidogrel in orally anticoagulated patients with acute coronary syndrome undergoing percutaneous coronary intervention. EuroIntervention. Published 15 May 2026. doi:10.4244/eij-d-25-01373
Summarised from the published abstract; every number is checked against it