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Abstract Older patients usually have more complex cardiovascular disease, more comorbidities, and mostly atypical clinical presentation. There is a greater prevalence of hypertension, congestive heart failure (CHF), cerebrovascular disease, renal insufficiency and anemia among older patients with ACS. Age also has important implications on both pharmacokinetics and pharmacodynamics Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y12 inhibitor, is essential for the prevention and treatment of atherosclerotic cardiovascular diseases. Clopidogrel is a platelet P2Y12 receptor blocker that is used with aspirin in patients undergoing percutaneous coronary interventions (PCIs) or in patients who have an acute coronary syndrome (ACS) to decrease the risk of subsequent major adverse cardiovascular events (MACE), such as stent thrombosis or recurrence of ACS. Ticagrelor is the first reversibly-binding P2Y12 antagonist for use in patients with ACS.Several trials showed superiority of ticagrelor versus clopidogrel in reducing cardiovascular death, myocardial infarction, and stroke. With increasing age, patients have higher risks of bleeding and thrombotic events, making the optimal choice of antithrombotic therapy challenging. Therefore, the aim of this study was to determine the optimal P2Y12 inhibitor in elderly patients with NSTEMI by assessing the safety and efficacy of clopidogrel compared with ticagrelor in patients aged 70 years or older. |