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Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention.
- Source :
- Heart; 4/15/2016, Vol. 102 Issue 8, p617-625, 9p, 5 Charts, 2 Graphs
- Publication Year :
- 2016
-
Abstract
- <bold>Objective: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.<bold>Trial Registration Number: </bold>NCT00391872; Results. [ABSTRACT FROM AUTHOR]
- Subjects :
- PERCUTANEOUS coronary intervention
CLOPIDOGREL
MYOCARDIAL infarction
SURGICAL stents
STROKE
PATIENTS
DRUG dosage
MYOCARDIAL infarction treatment
DRUG therapy
ADENOSINES
CARDIOVASCULAR system
COMBINED modality therapy
COMPARATIVE studies
DRUGS
DOSE-effect relationship in pharmacology
HOSPITAL care
LONGITUDINAL method
RESEARCH methodology
MEDICAL care
MEDICAL cooperation
NEUROTRANSMITTERS
RESEARCH
EVALUATION research
TICLOPIDINE
RANDOMIZED controlled trials
TREATMENT effectiveness
BLIND experiment
KAPLAN-Meier estimator
PLATELET aggregation inhibitors
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 13556037
- Volume :
- 102
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Heart
- Publication Type :
- Academic Journal
- Accession number :
- 114036089
- Full Text :
- https://doi.org/10.1136/heartjnl-2015-308963