Real-world Use of Ticagrelor versus Clopidogrel in PCI-treated STEMI Patients: A Single-Center Registry Study

Abstract Objectives The primary aim was to investigate the efficacy and safety of dual antiplatelet therapy (DAPT) using ticagrelor (T-DAPT) versus clopidogrel (C-DAPT), in a real-world STEMI population. Methods We retrospectively analysed 655 consecutive patients having primary PCI for STEMI at Liverpool Hospital, Sydney (Jan 2013-Apr 2016). Medical and procedural therapies were at clinician discretion. Patient data were retrieved from hospital records and primary clinicians. Results T-DAPT (65%) was used more frequently, and in patients with lower mean CRUSADE score, than C-DAPT (24.6 vs 32.2; p Conclusion Ticagrelor was preferred in low bleeding risk patients, which may have contributed to less BARC3-5 bleeding and lower mortality for T-DAPT. Thus bleeding mitigation is a clinical priority when selecting DAPT for PCI-treated STEMI patients. Continuation of initial DAPT regimen was typical, but early switching from clopidogrel to ticagrelor shows willingness to optimise DAPT. Patients with very low CRUSADE scores (