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. 2025 Jan 7;29(2):95-103.
doi: 10.14744/AnatolJCardiol.2024.4603. Online ahead of print.

Comparison of 1-Year Clinical Outcomes Between Ticagrelor Versus Clopidogrel in Type 2 Diabetes Patients After Implantation of Small Diameter Stents

Alaa S Algazzar  1 , Raghad M Aljondi  2 , Eilaf Majdi Metwalli  2 , Ghazal Y Dhaher  2 , Hanan H Mushaeb  2 , Renad H Aljadani  2 , Rahaf S Balahmar  2 , Awatif Hafiz  3 , Mohamed A Qutub  2
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Comparison of 1-Year Clinical Outcomes Between Ticagrelor Versus Clopidogrel in Type 2 Diabetes Patients After Implantation of Small Diameter Stents

Alaa S Algazzar et al. Anatol J Cardiol. .

Abstract

Background: Type 2 diabetes mellitus (T2DM) patients with small-diameter stents (SDS), that are equal to or less than 2.5 mm in diameter, face increased risks of restenosis and complications. This study aimed to evaluate the 1-year follow-up to assess the rate of major adverse cardiac events (MACE) and bleeding risk between ticagrelor and clopidogrel in T2DM patients after SDS implantation.

Methods: The study was a single-center, prospective controlled registry trial, which included 332 T2DM patients who underwent percutaneous coronary intervention with SDS implantation. Follow-up was conducted for 1 year.

Results: Following propensity score matching, the 1-year analysis revealed no significant difference in the risk of the composite MACE between clopidogrel and ticagrelor groups (P = .295). Male gender, history of ischemic heart disease, ejection fraction (EF), coronary lesion type, and chronic kidney disease (CKD) were identified as potential predictors for the composite endpoint. In a subanalysis of CKD patients, the 12-month rates of composites of cardiac death (CD), myocardial infarction (MI), stroke, and target vessel revascularization (TVR) were lower in the ticagrelor group than in the clopidogrel group (P = .024). However, the ticagrelor group was associated with a higher rate of bleeding compared to the clopidogrel group (20% vs. 9%) (P = .041).

Conclusion: Our study demonstrated that ticagrelor did not show improvement in the composite of CD, MI, stroke, TVR, or the risk of bleeding events defined by the BARC criteria in patients with T2DM and SDS compared with clopidogrel emphasizing the importance of individualized treatment decisions based on patient characteristics. However, the results may not be representative of the entire population.

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Conflict of interest statement

Declaration of Interests: The authors have no conflict of interests to declare.

Figures

Figure 1.
Figure 1.
Study flow chart.
Figure 2.
Figure 2.
Twelve-month cumulative incidence of cardiac death, MI, stroke, and TVR.
Figure 3.
Figure 3.
Twelve-month cumulative incidence of bleeding BARC 2, 3, and 5.
See this image and copyright information in PMC

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