Safety And Efficacy Of Low-Dose Ticagrelor In Patients With Unstable Angina Pectoris And Non-Revascularization

Objective To evaluate the safety and efficacy of low-dose ticagrelor in patients with unstable angina pectoris and non-revascularization.Methods 351 consecutive patients with unstable angina pectoris and non-revascularization were randomly assigned to group A(n = 108, ticagrelor 45 mg,bid), group B(n=132, ticagrelor 90 mg, bid) or group C(n=111, clopidogrel 75 mg, qd)for 12 months(all with aspirin 100 mg, qd). Three platelet function assessment methods which included light transmission aggregometry(LTA), the Verify Now assay and Vasodilator-stimulated phosphoprotein(VASP) were used to serially measure platelet function at various time points. The major adverse cardiovascular and cerebrovascular events(cardiovascular death, nonfatal myocardial infarction, stroke, target vessel revascularization and recurrent angina) and clinical complications were evaluated.Results Platelet function assessment at various time points demonstrated a higher antiplatelet effect in A group versus C group(P<0.05) and a lower antiplatelet effect in A group versus B group(P<0.05). There was no difference between A and B groups in the rates of the efficacy endpoints; the bleeding events occurred in fewer patients in the A group than in the B group(P<0.05). The efficacy endpoints(cardiovascular death,nonfatal myocardial infarction and target vessel revascularization) occurred in fewer patients in the A group than in the C group(P<0.05).Conclusion Low-dose ticagrelor seems to be a safe and efficacious option than standard dose of ticagrelor and clopidogrel for patients with unstable angina pectoris and non-revascularization.