A clinical trial to evaluate the safety and efficacy of ticagrelor in bangladeshi patients with acute coronary syndrome (acs) undergoing percutaneous coronary intervention (pci) [glorious trial]

Background: In several clinical trials, Ticagrelor was superior to Clopidogrel in reducing cardiovascular events among patients with Acute Coronary Syndrome (ACS). We evaluated the safety and efficacy of Ticagrelor in Bangladeshi ACS patients undergoing Percutaneous Coronary Intervention (PCI).
Methods: Applying the inclusion and exclusion criteria, patients were allocated to Ticagrelor group or Clopidogrel group. After the procedure, the patients were followed up for 12 months .The primary endpoint of efficacy (death, myocardial infarction [MI] and stroke), and safety (bleeding, and dyspnea) were evaluated and compared between the two groups.
Results: 163 patients with ACS were recruited and 93 patients were assigned to Ticagrelor group and 70 patients to Clopidogrel group. The primary endpoint occurred in fewer patients in Ticagrelor group than in Clopidogrel group (10% in Clopidogrel and 3.2% in Ticagrelor group; p= 0.13). There was significant increase in the incidence of bleeding and dyspnea in Ticagrelor group ( minor bleeding occurred in 1.4% of patients in Clopidogrel and 5.4% of patients in Ticagrelor group , and dyspnea occurred in 1.4% of patients in the Clopidogrel group and 12.9% of patients in Ticagrelor group; p= 0.009).
Conclusion: Ticagrelor numerically reduced the risk of death in ACS patients undergoing PCI, but the incidence of minor bleeding and dyspnea were significantly more with Ticagrelor compared to Clopidogrel in Bangladeshi patients.