Study of effectiveness of antiplatelet therapy in patients taking aspirin and clopidogrel or ticagrelor after acute ischaemia syndrome without ST segment elevation

Aim of the study – to determine and compare the effectiveness of two antiplatelet therapies in patients taking aspirin and ticagrelor or clopidogrel, taking into consideration clinical and genetic factors and drug interaction effect on platelet aggregation. Goals of the study – to evaluate and compare platelet aggregation in patients taking aspirin and clopidogrel or ticagrelor after acute ischaemia syndrome; to determine the effects of diabetes mellitus, drug interaction and gene CYP2C19 *2 polymorphism on platelet aggregation. Methods and participants of the study – we studied 146 patients after acute ischaemia syndrome without ST segment elevation; 82 patients were treated with aspirin and clopidogrel combination at the Cardiology Department of Kaunas Clinical Hospital, and 64 patients were treated with aspirin and ticagrelor combination at the Cardiology department of Kaunas Clinics of Hospital of Lithuanian University of Health Sciences. All patients had platelet aggregation and genetic tests; clinical data was collected from medical documentation. Then statistical data analysis was performed. Results – study shows that platelet aggregation was lower in patients taking ticagrelor than those taking clopidogrel, regardless effect of ADP and ADR (p=<0.0001). Diabetes had no effect on platelet aggregation in patients taking ticagrelor. We did not find any drug interaction that could affect platelet aggregation. Platelet aggregation remained lower in those taking ticagrelor. We also found that platelet aggregation was higher in those taking clopidogrel with heterozygote CYP2C19 *1*2 genotype than those with CYP2C19 *1*1 genotype, regardless effect of ADP or ADR (p