Review of the Ticagrelor Trials Evidence Base

Abstract

Ticagrelor is a platelet P2Y 12 receptor inhibitor approved for use in patients with acute coronary syndromes, coronary artery disease, and low‐moderate risk acute ischemic stroke or high‐risk transient ischemic attack. Clinical trials have evaluated the efficacy and safety of ticagrelor on ischemic and bleeding outcomes for different indications and with varying treatment approaches. As a result, there is a large body of clinical evidence demonstrating different degrees of net clinical benefit compared with other platelet inhibitor drugs based on indication, patient characteristics, clinical presentation, treatment duration, and other factors. We provide a review of the major trials of ticagrelor in the context of other randomized trials of clopidogrel and prasugrel to organize the volume of available information, elevate corroborating and conflicting data, and identify potential gaps as areas for further exploration of optimal antiplatelet treatment.