The effect of P2Y12 Receptor Inhibitors on Clinical Outcomes in Patients with Acute Coronary Syndrome Undergoing Primary Percutaneous Intervention and Receiving Abciximab

Background: Our study compared the effect of P2Y12 receptor inhibitors in combination with abciximab on clinical outcomes in patients with acute coronary syndrome (ACS). Methods: Our study is retrospective, consisting of 852 consecutive ACS patients who presented to our clinic between 2015 and 2021, underwent primary percutaneous coronary intervention (PCI), and received abciximab in addition to dual antiplatelet therapy. The P2Y12 receptor inhibitors were compared in terms of in-hospital and 1-year major adverse cardiac events (MACE), and clinically significant in-hospital and 1-year bleeding complications. Results: The patients' mean age was 60.4 +/- 11 years, and 702 (82.4%) were male. In-hospital MACE, in-hospital mortality, 1-year MACE, and 1-year mortality were significantly higher in the clopidogrel group compared to the ticagrelor group. There was no significant difference in the development of in-hospital and 1-year bleeding between clopidogrel and the more potent P2Y12 receptor inhibitors. According to the BARC score, there was no difference in major bleeding between ticagrelor and clopidogrel (p = 0.641), but minor bleeding was significantly lower in the ticagrelor group (p < 0.001). In logistic regression analysis, the 1-year MACE rate was lower in the potent P2Y12 receptor inhibitors group compared to clopidogrel. At the same time, no association was found with short-and long-term mortality, bleeding, or in-hospital MACE. Conclusions: In our study, potent P2Y12 receptor inhibitors combined with abciximab decreased 1-year MACE without significantly increasing bleeding in ACS patients undergoing PCI compared to clopidogrel. This study suggests that potent P2Y12 receptor inhibitors can be safely used with abciximab, considering the bleeding risk.