Summary

A quick summary of the project can be found here

Is the study ethical?

YES is the short answer.
While the CCS guidelines (2012) recommend ticagrelor over clopidogrel,
* US guidelines (2012) listed both drugs as being comparable but did mention an increased concern about bleeding with ticagrelor
* More recently, the ESC in their 2018 Revasculation Guidelines state that both ticagrelor and clopidogrel are appropriate as antiplatelet agents and make no recommendation for one over the other
* This trial has also been judged ethical by CIHR (funding agency) and the McGill University Hospital Center Research Ethics Board
* Members of the CUSM/MUHC Division of Cardiology have judged that the necessary clinical equipoise exists to perform this study
* At the time of ticagrelor approval, the FDA recommended a confirmation study in North American patients but that study has never been done, until now!

As a MD what do I have to do?

• We ask you simply to continue the DAPT initiated during your patient’s MUHC stay
  
• You decide on the duration of the therapy according to your usual criteria. Generally, DAPT is continued for 12 months unless there are special circumstances
  
• Obviously if you feel strongly that a different DAPT is in your patient’s best interest then you are free to make the change.

As a patient what do I have to do?

The success of this, and any study, depends on patients staying on their assigned therapy. Please continue your therapy until your treating MD tells you otherwise.