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Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention.
- Source :
-
Heart (British Cardiac Society) [Heart] 2016 Apr; Vol. 102 (8), pp. 617-25. Date of Electronic Publication: 2016 Feb 04. - Publication Year :
- 2016
-
Abstract
- Objective: The effects of ticagrelor in the subpopulation of patients with ST-elevation myocardial infarction (STEMI) were consistent with those observed in the overall Platelet Inhibition and Patient Outcomes (PLATO) study. However, this subgroup included patients initially or ultimately treated conservatively. The aim of this study is to compare treatment using ticagrelor with treatment using clopidogrel in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).<br />Methods: This post-hoc subgroup analysis compared ticagrelor with clopidogrel in 4949 PLATO patients with STEMI that were treated with primary PCI within 12 h of admission. The primary endpoint was cardiovascular death, myocardial infarction or stroke. The safety endpoint consisted of any major bleeding. Secondary endpoints included stent thrombosis. The analysis was not adequately powered to establish significance of any treatment effects.<br />Results: During a median of 286 days, the primary endpoint occurred in 7.9% of ticagrelor-treated patients versus 8.6% of clopidogrel-treated patients (HR 0.91, 95% CI 0.75 to 1.12, p=0.38). Major bleeding occurred in 6.7% in ticagrelor-treated patients versus 6.8% of clopidogrel-treated patients (HR 0.97, 95% CI 0.77 to 1.22, p=0.79). No interactions were observed for the treatment effect of ticagrelor versus clopidogrel on the primary efficacy (p=0.40) and primary safety endpoints (p=0.15) as compared with the full PLATO population. Treatment with ticagrelor versus clopidogrel reduced the occurrence of definite stent thrombosis (HR 0.58, 95% CI 0.37 to 0.89, p=0.013).<br />Conclusions: In the subset of patients with STEMI treated with primary PCI, ticagrelor compared with clopidogrel was safe, and efficacy outcomes were consistent with the overall PLATO trial.<br />Trial Registration Number: NCT00391872; Results.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Subjects :
- Adenosine administration & dosage
Adenosine adverse effects
Adenosine therapeutic use
Aged
Clopidogrel
Combined Modality Therapy
Dose-Response Relationship, Drug
Double-Blind Method
Female
Follow-Up Studies
Hospitalization statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Platelet Aggregation Inhibitors administration & dosage
Platelet Aggregation Inhibitors adverse effects
Purinergic P2Y Receptor Antagonists administration & dosage
Purinergic P2Y Receptor Antagonists adverse effects
Purinergic P2Y Receptor Antagonists therapeutic use
Ticagrelor
Ticlopidine administration & dosage
Ticlopidine adverse effects
Ticlopidine therapeutic use
Treatment Outcome
Adenosine analogs & derivatives
Myocardial Infarction therapy
Percutaneous Coronary Intervention methods
Platelet Aggregation Inhibitors therapeutic use
Ticlopidine analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 102
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 26848185
- Full Text :
- https://doi.org/10.1136/heartjnl-2015-308963