Safety of Ticagrelor in Post – PCI (Percutaneous Coronary Intervention) Patients at a Tertiary Care Hospital

Background: Coronary artery disease (CAD) remains a leading cause of mortality and morbidity worldwide, despite advances in diagnosis and management. In acute coronary syndrome (ACS) patients, the combination of aspirin and clopidogrel is the standard therapy against recurrent cardiovascular events. However, clopidogrel has a delayed onset and variability in platelet response. Objective: To examine the safety profile of ticagrelor in post-PCI patients at a tertiary care hospital. Methods: This descriptive study was conducted at the Department of Cardiology, North-West General Hospital, Peshawar, from 1st April 2023 to 31st March 2024. Patients aged 30 to 80 years who underwent PCI and were started on ticagrelor were included. Baseline data such as age, gender, BMI, and cardiovascular risk factors (smoking, hypertension, diabetes mellitus) were collected. Patients received a loading dose of ticagrelor 180 mg orally followed by 90 mg twice daily. Adverse effects, including bleeding, dyspnea, and arrhythmias, were evaluated within 24 hours and at one-month follow-up. Data were analyzed using IBM SPSS version 25, with categorical variables presented as frequencies and percentages, and quantitative variables as means and standard deviations. Results: A total of 137 post-PCI patients participated in the study, with a mean age of 58 ± 10 years. The cohort included 85 men (62%) and 52 women (38%). The average BMI was 27.5 ± 3.5 kg/m². Risk factors included smoking (30%), hypertension (45%), and diabetes mellitus (25%). Within 24 hours, minor bleeding occurred in 10 patients (7.3%), dyspnea in 15 patients (10.9%), and arrhythmias in 4 patients (2.9%). At the one-month follow-up, minor bleeding was observed in 12 patients (8.8%), major bleeding in 2 patients (1.5%), dyspnea in 18 patients (13.1%), and arrhythmias in 5 patients (3.6%). Conclusion: The study supports the safety of ticagrelor as an antiplatelet therapy in post-PCI patients, with manageable adverse effects. However, careful monitoring for complications such as bleeding, dyspnea, and arrhythmias is recommended.