LOwer Maintenance Dose TICagrelor in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

LOwer Maintenance Dose TICagrelor in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

The hypothesis in this study was that ticagrelor switched to 60 mg after 1 month of standard dose, with antiplatelet activity that is not inferior to the standard dose and better than 75 mg clopidogrel for patients with ACS after PCI.

Inclusion Criteria:

• Agree to sign the Informed Consent;
• Male or female, ≥ 18 years of age, and ≤ 70 years of age
• Patient presents with acute coronary syndrome (ACS)
• Planned to undergo PCI
• Planned to DAPT for 1 year after PCI

Exclusion Criteria:

• Treatment with other investigational agents (including placebo) or devices within 30 days prior to randomization or planned use of investigational agents or devices prior to the Day 30 visit.
• Patients cannot use ticagrelor or clopidogrel due to contraindications or other reasons.
• Patients with active pathological hemorrhage or a history of intracranial hemorrhage
• Patient unable to receive 12 months of dual anti-platelet therapy
• Patient developing procedure-related complications such as stent thrombosis, coronary dissection, coronary perforation, cardiac tamponade or no-reflow during PCI
• Patient or physician refusal to enroll in the study
• History of intracranial hemorrhage
• Patient has a history of bleeding diathesis or coagulopathy
• Patient has an active pathological bleeding, such as active gastrointestinal (GI) bleeding
• Patient is pregnant, breastfeeding, or planning to become pregnant within 12 months
• Patient is receiving chronic oral anticoagulation therapy (i.e., vitamin K antagonist, direct thrombin inhibitor, Factor Xa inhibitor)
• Patient with cardiogenic shock or mechanical circulatory assist devices placed
• Patient with active liver diseases
• Patient with severe renal insufficiency (eGFR <30ml/min/1.73m2 based on simplified MDRD equation or CrCl <30ml/min based on Cockcroft-Gault equation)
• Patient has a malignancy or a life expectancy of less than one year
• Platelet count <100 000/μL, or hematocrit <32% or >52%, or white blood cell count <3000/μL
• Any other condition deemed by the investigator to place the patient at excessive risk of bleeding with ticagrelor