Silvain J, Lattuca B, Beygui F, et al. - Whether ticagrelor was superior to clopidogrel in decreasing periprocedural myocardial necrosis among stable coronary patients receiving high-risk elective percutaneous coronary intervention (PCI), was determined in a phase 3b, randomised, open-label trial, named the ALPHEUS study. The eligible patients were randomized (1:1) to either ticagrelor (180 mg loading dose, 90 mg twice daily thereafter for 30 days) or clopidogrel (300–600 mg loading dose, 75 mg daily thereafter for 30 days). Findings showed no superiority of ticagrelor to clopidogrel in attenuating periprocedural myocardial necrosis following elective PCI. Ticagrelor did not result in an increase in major bleeding but was associated with an elevated rate of minor bleeding at 30 days. In view of these observations, the use of clopidogrel as the standard of care for elective PCI was supported.