Comparative Effect of Ticagrelor and Clopidogrel on Left Ventricular Remodeling in Acute Coronary Syndrome Patients: A Retrospective Cohort Study.

Ticagrelor was associated with a greater reduction in LV end-diastolic volume compared with clopidogrel after PCI in ACS patients.

• Adjusted LVEDV reduction of 8.17 mL with ticagrelor compared to clopidogrel (95% CI -15.84 to -0.50; P = .039).
• Analysis was based on multivariable regression models adjusted for confounders.
• Total cohort included 137 patients: 87 on ticagrelor and 50 on clopidogrel.
• Echocardiographic data were assessed at baseline and within one-year follow-up.

Ticagrelor was associated with a greater reduction in LV end-systolic volume compared with clopidogrel.

• Adjusted LVESV reduction of 8.09 mL with ticagrelor compared to clopidogrel (95% CI -13.88 to -2.29; P = .007).
• This finding was statistically significant after multivariable adjustment.
• Patients were required to have been prescribed ticagrelor or clopidogrel for at least 3 months after PCI and to have complete echocardiographic data.

Ticagrelor was associated with a greater improvement in LV ejection fraction compared with clopidogrel.

• Adjusted LVEF improvement was 4.05% greater with ticagrelor compared to clopidogrel (95% CI 2.41-5.70; P < .001).
• This was the most statistically significant of the echocardiographic findings (P < .001).
• Eligible participants were adults (≥18 years) with confirmed ACS who underwent PCI.

Ticagrelor was associated with a greater reduction in B-type natriuretic peptide compared with clopidogrel.

• The reduction in BNP was greater with ticagrelor by 73.56 pg/mL (95% CI -144.08 to -3.05; P = .043).
• BNP was assessed alongside echocardiographic parameters as a marker of cardiac remodeling.
• Patients who switched between antiplatelets, had contraindications to DAPT, or were noncompliant were excluded from the analysis.

The study population consisted of 137 ACS patients post-PCI who met eligibility criteria for inclusion in the retrospective cohort.

• 87 patients were on ticagrelor and 50 were on clopidogrel.
• Inclusion required confirmed ACS, antiplatelet therapy for at least 3 months after PCI, and complete echocardiographic data at baseline and within one-year follow-up.
• Exclusion criteria included missing follow-up imaging, switching between antiplatelets, contraindications to DAPT, or noncompliance.
• The study design was a retrospective cohort study.