Comparable Effects of Ticagrelor and Clopidogrel Based on Platelet Aggregation Test in Patients with Acute Coronary Syndrome

Abstract

Ticagrelor and clopidogrel are P2Y₁₂ receptor inhibitors commonly administered as part of dual antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Although ticagrelor demonstrates a more rapid onset of action and stronger platelet inhibition than clopidogrel in pharmacodynamic studies, its superiority in routine clinical practice remains debated. This study aimed to compare the effects of ticagrelor and clopidogrel on platelet aggregation in ACS patients undergoing PCI. A cross-sectional comparative study was conducted involving 33 ACS patients who were consecutively recruited from patients undergoing PCI and receiving either ticagrelor or clopidogrel. Platelet aggregation was evaluated using light transmission aggregometry with adenosine diphosphate (ADP) as the agonist at concentrations of 1, 2, 5, and 10 µM. Differences in platelet aggregation between treatment groups were analyzed using the Mann–Whitney U test. No statistically significant differences in platelet aggregation were observed between the ticagrelor and clopidogrel groups at all ADP concentrations tested (all p > 0.05). These findings suggest comparable platelet inhibitory effects between both P2Y₁₂ inhibitors in ACS patients undergoing PCI. Ticagrelor and clopidogrel demonstrated similar platelet aggregation profiles, indicating comparable platelet reactivity under both treatment regimens in ACS patients undergoing PCI in real-world clinical settings.