In individuals who presented with acute coronary syndromes (ACS) and active COVID-19, who were treated with urgent coronary angioplasty, Ticagrelor in comparison with Clopidogrel did not considerably reduce myocardial infarction, all-cause mortality, or early stent thrombosis in 30-day follow-up, according to the findings of a randomized clinical trial.

ACS-affected patients are more prone to experience negative clinical outcomes when they have an acute COVID-19 disease. This multicenter study sought to examine influence of Clopidogrel and Ticagrelor on the short-term outcomes of these patients because some studies revealed enhanced lung function with Ticagrelor. 

Overall, 180 COVID-19 people with ACS who underwent urgent percutaneous coronary intervention (PCI) were randomized to get Ticagrelor (180 mg loading dose followed by 90 mg twice daily, n=90) or Clopidogrel (600 mg loading dose with 75 mg daily, n=90), and they were then monitored for one month following their procedure. Early stent thrombosis, all-cause mortality, and myocardial infarction during the first month following stent implantation was the key composite outcome.

The key composite endpoint was non-significantly reduced in the Ticagrelor group compared to the Clopidogrel group following 30 days of follow-up (18.5% vs 23.5% respectively). The mean survival rates were higher in the Ticagrelor group according to the time-to-event analysis.  The secondary outcomes were comparable in the study groups, with the exception of the mean oxygen saturation, which was greater in the Ticagrelor group, as illustrated in Table 1:

The composite result of mortality, myocardial infarction, and early stent thrombosis among coronavirus-infected patients with concurrent ACS who were treated with urgent PCI did not differ between the Ticagrelor and Clopidogrel groups. Ticagrelor use was linked with a slight but considerable rise in oxygen saturation compared to Clopidogrel. However, this difference was not clinically vital.