Ticagrelor Monotherapy Compared to Aspirin Monotherapy in Patients With History of ACS
Completed
The University of Hong Kong
Phase 4
2017-01-01
Antiplatelet agents are cornerstones for management of ischemic heart disease. For patients
suffering from acute coronary syndrome (heart attack), treatment with aspirin and ticagrelor
are typically given for one year after index heart attack and then patients will continue to
take aspirin lifelong. However, these patients are still having increased risk of suffering
from another heart attack. Recently data showed that adding ticagrelor to aspirin in the long
term can decrease the chance of recurrent heart attack but at the cost of increased risk of
major bleeding. On the other hand, ticagrelor is a potent antiplatelet agent and has been
showed to have additional benefit on blood vessels and platelets. The investigator
hypothesize that monotherapy with ticagrelor may have further benefit over monotherapy with
aspirin in the long term management in patients with history of heart attack. The
investigator plan to perform a randomized study to compare the outcome in patients taking
either ticagrelor or aspirin. The primary endpoint is measurement of endothelial function by
flow mediated dilatation of brachial artery which is a surrogate marker of adverse
cardiovascular outcome 3 months after treatment. The investigator would also investigate
secondary endpoints of patients' blood level of adenosine activity, platelet function,
endothelial progenitor cell count and biomarkers
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