Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pharmacology

Background and Objective: Recent guidelines consider percutaneous coronary intervention (PCI) with stent placement as a safe procedure in patients with stable coronary artery disease (SCAD) and it can improve the quality of life compared with the strategy of medical therapy. Oral anti-platelet agents, particularly aspirin in combination with ADP receptor blocker such as clopidogrel or ticagrelor constitute a cornerstone of therapy for these patients to reduce the risk of periprocedural and post-procedural ischemic events. To our knowledge, ticagrelor has not been well evaluated in elective PCI compared to clopidogrel, the currently recommended treatment Aim of the work: The aim of this work is to compare the clinical safety and efficacy of clopidogrel versus ticagrelor, as a part of dual anti-platelet therapy, in patients undergoing elective percutaneous coronary intervention with determination of actual plasma concentrations and the platelet inhibitory effect of both drugs by the help of ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and light transmission aggregometry (LTA) respectively. Methods: A total of 60 patients diagnosed with SCAD were enrolled in this study and scheduled for PCI. In addition to aspirin, half of the Patients received clopidogrel, 600 mg loading dose and 75mg daily thereafter. The other thirty patients received ticagrelor at a loading dose of 180mg and 90 mg twice daily thereafter. Detailed history of patients was taken before the PCI, including age, sex, BMI, presence of cardiovascular risk factors as hypertension, diabetes mellitus, hyperlipidemia, smoking, positive family history and medications on admission

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