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The pivotal PLATelet inhibition and Patient Outcomes (PLATO) study evaluated ticagrelor vs clopidogrel for reduction of thrombotic events in patients with acute coronary syndrome. African Americans (AAs) have a high mortality rate from coronary artery disease (CAD). However, their participation in clinical studies is limited. The aim of the present study was to compare the pharmacodynamics (PD) of ticagrelor vs clopidogrel in AAs with stable CAD.
A multicenter, randomized, open-label, crossover PD study was conducted in aspirin (75–100mg/day) treated AA patients with stable CAD. Patients were randomized to receive either ticagrelor (180 mg loading dose [LD] followed by 90 mg twice-daily maintenance dose [MD] for 7–9 days) or clopidogrel (600 mg LD followed by 75 mg once-daily MD for 7–9 days). After a 10–14 day washout period, patients crossed over therapy. Platelet reactivity was measured with the VerifyNow P2Y12 function assay at the following time-points: 0.5, 2 and 8h following LD and 0, 2, 8 and 12–24h following MD.
A total of 34 AA patients were randomized. At all post-dose time points, on-treatment platelet reactivity was lower for ticagrelor versus clopidogrel (Figure).
In AA patients with stable CAD on daily low-dose aspirin, ticagrelor provided a faster onset and greater extent of platelet inhibition than clopidogrel.
↵∗ Indicates iMPACT Trial Accepted for Oral Presentation