Lessons from platelet inhibition and patient outcomes

Current Opinion in Cardiology
Claes Held

Abstract

Ticagrelor is a new, direct acting, reversibly binding P2Y12 receptor antagonist with more potent inhibition of platelets than clopidogrel and which does not require metabolic activation. It was compared with clopidogrel, on a background of the standard of care in a randomized trial in the Platelet Inhibition and Patient Outcomes (PLATO) study, on patients with acute coronary syndrome (ACS). The purpose was to evaluate the efficacy and safety results from the global, prospective trial in a broad population [ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) patients] with ACS. The main findings were a significant reduction of the primary outcome (death from vascular causes/myocardial infarction/stroke) with ticagrelor versus clopidogrel [9.8 versus 11.7% (hazard ratio 0.84; 95% confidence interval: 0.77-0.92); P < 0.001] without a significant increase in PLATO-defined major bleeding (11.6 versus 11.2%, respectively; P = 0.43), but a higher occurrence of noncoronary artery bypass grafting (CABG) related major bleeding (4.5 versus 3.8%; P = 0.026). In addition, there was a significant reduction in vascular mortality (4.0 versus 5.1%; P = 0.001). The findings were consistent in all subgr...Continue Reading

References

Dec 17, 2008·European Heart Journal·Frans Van de Werf
Jul 17, 2009·Cardiovascular Therapeutics·Steen Husted, J J J van Giezen
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Jan 19, 2010·Lancet·Christopher P CannonUNKNOWN PLATelet inhibition and patient Outcomes Investigators
Jan 21, 2012·Circulation·Shaun G GoodmanUNKNOWN Platelet Inhibition and Patient Outcomes Trial Investigators
Feb 7, 2012·Biochemical and Biophysical Research Communications·Jenny OhmanDavid Erlinge

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