Post-Percutaneous Transluminal Coronary Angioplasty Acute Dyspnea in Acute Coronary Syndrome Patients: Ticagrelor versus Clopidogrel at Tertiary Cardiac Center: A Cross-Sectional Study

Abstract

Objective: To compare the frequency of new-onset acute dyspnea in acute coronary syndrome patients undergoing PTCA receiving Ticagrelor versus Clopidogrel.
Study Design: Quasi-experimental study.
Place and Duration of Study: This study was conducted at the Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan, from 30^th September 2025 to 30^th March 2026.
Methods: A total of 198 male patients aged 50–75 years who underwent percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS) were enrolled and allocated into two groups: Experimental Group (N=99) received ticagrelor plus aspirin, and Control Group (N=99) received clopidogrel plus aspirin. Post-procedural dyspnea was assessed as the primary outcome within 8–24 hours post-procedure using the Modified Borg Acute Dyspnea Scale (0–4), with follow-up evaluations at one, two, and three months.
Results: A total of 198 male patients with ACS who underwent PTCA were included in the study. Mean patient age was 67.41±3.83 years. Dyslipidemia was the most common comorbidity, present in 140 patients (70.7%), followed by smoking in 111 (56.1%), diabetes mellitus in 104 (52.5%), and hypertension in 86 (43.4%). In hospital dyspnea was significantly more frequent with ticagrelor (57.6%) than with clopidogrel (12.1%) (P<0.001). Dyspnea frequency declined progressively in both groups across follow-ups; at three months, only 3.0% of ticagrelor and 1.0% of clopidogrel patients remained symptomatic. A significant within-group decline
was observed in both groups over the follow-up period (P<0.001).
Conclusion: Ticagrelor was associated with a significantly higher incidence of dyspnea compared with clopidogrel among patients with acute coronary syndrome undergoing PTCA, particularly during the in-hospital period. Most episodes were mild and self-limiting, supporting continued use given its established cardiovascular benefits.

How to cite this: Ashraf T, Bhatti QZ, Siddique MB, Mushtaq H, Ahmad H, Kamran J. Post-Percutaneous Transluminal Coronary
Angioplasty Acute Dyspnea in Acute Coronary Syndrome Patients: Ticagrelor versus Clopidogrel at Tertiary Cardiac Center: A Cross-
Sectional Study. Life and Science. 2026; 7(3): 373-379. doi: http://doi.org/10.37185/LnS.1.1.1185