The new network study is launched to evaluate the efficacy and safety ticagrelor on top of aspirin in patients with acute coronary syndrome compared to clopiodogrel.
Net Adverse Clinical Event between Ticagrelor versus Clopidogrel in patients with Acute Coronary Syndrome
Objective : The goal of this protocols is conducting comparative effectiveness research to establish evidences for benefits and harms of ticagrelor and clopidogrel in patients with acute coronary syndrome through OHDSI network.
Rationale : The 2016 American College of Cardiology / American Heart Association (ACC/AHA) guideline and 2017 European Society of Cardiology (ESC) / European Association for Cardio-Thoracic Surgery (EACTS) guideline recommended to use ticagrelor on top of aspirin in preference to clopidogrel for patients with acute coronary syndrome (ACS) based on the results from randomized clinical trials (RCT). The study of PLATelet inhibition and patient Outcomes (PLATO) demonstrated the ticagrelor reduced the rate of death from vascular causes, myocardial infarction, or death, with an increase in the rate of non-procedural-related bleeding.
Still, the real-world evidence evaluating net clinical benefit of ticagrelor over clopidogrel has been scarce. Furthermore, there is a concern that non-White patients, especially Asians and Black people, might be susceptible to anti-thrombotic therapy because of excessive bleeding risk.In PLATO trial, indeed, Caucasian patients formed most of the enrolled patients, up to 92%. The meta-analysis using RCT of East Asian patients reported that ticagrelor was associated with higher risk of major bleeding without significant lower risk of vascular death, myocardial infarction, or stroke.
Hence, we aimed to conduct comparative effectiveness research to establish real-world evidences for benefits and harms of ticagrelor and clopidogrel in patients with acute coronary syndrome through OHDSI network.
We are searching for collaborators to join this network study. Please let me know if you’re interested in joining this study! And please provide any comments or suggestions.