Platelet Inhibition With Ticagrelor 60 mg Versus Ticagrelor 90 mg in Elderly Patients With ACS
Status:
Recruiting
Trial end date:
2022-02-01
Target enrollment:
Participant gender:
Summary
Elderly individuals are increasingly represented among patients with acute coronary syndrome
(ACS). Dual antiplatelet therapy (DAPT) with aspirin and an oral P2Y12 receptor inhibitor has
an established role in the prevention of atherothrombotic events in ACS setting. However,
DAPT in older patients is challenged by a concurrent heightened risk of ischemia and
bleeding. Although guidelines recommend DAPT with aspirin and ticagrelor for elderly patients
with ACS, clopidogrel, a less potent antiplatelet agent, continues to be used in more than
one third of ACS patients with elderly status being the strongest predictor of
undertreatment. A lower dose of ticagrelor may represent an alternative to the standard dose
by conferring a similar efficacy and, potentially, a better safety profile. Our prospective,
randomized, double-blind, crossover trial will test the hypothesis that a lower dose of
ticagrelor provides similar antiplatelet effects compared with a standard dose among elderly
patients with ACS.
The main aim of the trial is to determine the pharmacodynamic and pharmacokinetic profile of
ticagrelor 60 mg twice daily versus ticagrelor 90 mg twice daily among elderly patients with
ACS undergoing PCI.
This will be a prospective, randomized (1:1 ratio), non-inferiority, open-label, crossover
trial to evaluate the level of platelet inhibition achieved with a low-dose of ticagrelor (60
mg twice daily) versus a standard dose of ticagrelor (90 mg twice daily) among elderly
patients with ACS undergoing PCI.