Effects of Low-dose Ticagrelor vs. Clopidogrel in Stable Patients Undergoing Elective Percutaneous Coronary Intervention

Eligibility Criteria

• 1. Stable CAD undergoing elective PCI;
• 2. Male or females, Age ≥ 18 years old;
• 3. Troponin negative before coronary angiography;
• 4. On treatment with low-dose aspirin (81mg od) and clopidogrel for at least 24 hours after index PCI;
• 5. ABCD-GENE score greater or equal than 10.
• 1. Myocardial infarction at the time of index PCI;
• 2. On treatment with prasugrel or ticagrelor;
• 3. Documented hypersensitivity to clopidogrel;
• 4. Use of an intravenous antiplatelet therapy (i.e., cangrelor or GPI) in the prior 24 hours;
• 5. Concomitant therapy with strong CYP3A4 inhibitors or CYP3A4 substrates;
• 6. Use of oral anticoagulant therapy;
• 7. History of previous intracerebral bleed at any time;
• 8. Active pathological bleeding;
• 9. Documented hypersensitivity to ticagrelor;
• 10. Increased risk of bradycardic events (e.g., known sick sinus syndrome, second or third degree AV block or previous documented syncope suspected to be due to bradycardia) unless treated with a pacemaker;
• 11. Known severe liver disease;
• 12. Known platelet count \<80x106/mL;
• 13. Known hemoglobin \<9 g/dL;
• 14. Women of child-bearing potential (i.e., those who are not chemically or surgically sterilized or who are not post-menopause) who are not willing to use a medically accepted method of contraception that is considered reliable in the judgment of the investigator OR who have a positive pregnancy test at enrollment or randomization OR women who are breast-feeding.
• 15. Inability to provide written informed consent.