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JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-021

Safety and Efficacy of Ticagrelor or Clopidogrel in East Asian Patients With Acute Coronary Syndrome and Diabetes Mellitus

By Yeonwoo Choi, Hoyun Kim, Jinho Lee, Do-Yoon Kang, Jung-Min Ahn, Duk-Woo Park, Seung-Jung Park

Presenter

Yeonwoo Choi

Authors

Yeonwoo Choi1, Hoyun Kim1, Jinho Lee1, Do-Yoon Kang1, Jung-Min Ahn1, Duk-Woo Park1, Seung-Jung Park1

Affiliation

Asan Medical Center, Korea (Republic of)1
View Study Report
TCTAP A-021
Acute Coronary Syndromes (STEMI, NSTE-ACS)

Safety and Efficacy of Ticagrelor or Clopidogrel in East Asian Patients With Acute Coronary Syndrome and Diabetes Mellitus

Yeonwoo Choi1, Hoyun Kim1, Jinho Lee1, Do-Yoon Kang1, Jung-Min Ahn1, Duk-Woo Park1, Seung-Jung Park1

Asan Medical Center, Korea (Republic of)1

Background

It is still unknown whether diabetes mellitus (DM) affects the relative safety and efficacy of ticagrelor and clopidogrel in East Asian patients with ACS. We investigated the safety and efficacy of ticagrelor versus clopidogrel according to the diabetic status of patients with acute coronary syndrome (ACS) intended for invasive management.

Methods

This prespecified analysis of the TICAKOREA (Ticagrelor Versus Clopidogrel in Asian/Korean Patients with ACS Intended for Invasive Management) trial included 800 Korean patients hospitalized for ACS randomized to ticagrelor or clopidogrel. The primary safety end point was clinically significant bleeding (PLATO major or minor bleeding) at 12 months; the efficacy end point was a major adverse cardiovascular event (MACE; a composite of cardiovascular death, myocardial infarction, or stroke).

Results

Of 800 patients, 216 (27.0%) had DM. The incidence of primary safety end point within 12 months was higher with ticagrelor than clopidogrel in patients with DM (13.8% vs. 8.0%; hazard ratio [HR], 1.87; 95% confidence interval [CI], 0.54-4.36) and in those without DM (10.2% vs. 4.3%; HR 2.45; 95% CI, 1.27-4.70); there was no significant interaction between treatment arm and diabetic status (P-for-interaction = 0.64). The incidence of MACE within 12 months also tended to be higher with ticagrelor than with clopidogrel in patients with DM (10.8% vs. 6.0%; HR, 1.90; 95% CI, 0.71-5.07) and in those without DM (8.5% vs. 5.7%; HR 1.51; 95% CI, 0.81-2.81) without any significant interaction between treatment arm and diabetic status (P-for-interaction = 0.71).

Conclusion

In Korean ACS patients undergoing early invasive management, diabetes status did not affect the relative safety and efficacy of ticagrelor and clopidogrel.

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