Li XY, et al. - In patients with ST-segment elevation myocardial infarction (STEMI) undergoing successful primary percutaneous coronary intervention (PCI), researchers evaluated the incidence, reasons and outcomes of switching from ticagrelor to clopidogrel. Before PCI, a loading dose of ticagrelor or clopidogrel was randomly given to 653 patients with STEMI. These subjects then received a maintenance dose for 12 months follow-up. Major adverse cardiac events (MACE), including cardiovascular death, non-fatal myocardial infarction and stroke, was the primary outcome. According to findings, a switch from ticagrelor to clopidogrel was commonly seen in patients with STEMI in China, mostly attributed to financial burden. Findings also suggested that de-escalation might be safe, but related to a high risk of ischemic events, compared to ticagrelor.