Reduction in First and Recurrent Cardiovascular Events With Ticagrelor Compared With Clopidogrel in the PLATO Study

• DOI: 10.1161/circulationaha.112.124248
• Publication Date: 2013-01-01T02:11:45Z
• Authors: Payal Kohli; Lars Wallentin; Eric Reyes; Jay Horrow; Steen Husted; Dominick J. Angio...; Diego Ardissino; Gerald Maurer; Joao Morais; José C. Nicolau; Ali Oto; Robert F. Storey; Stefan K. James; Christopher P. Ca...
• Keywords: Stroke

We sought to evaluate the effect of potent platelet inhibition after acute coronary syndrome on total (ie, first and recurrent) occurrences any primary outcome events (e.g., cardiovascular death, myocardial infarction, stroke) as well other ischemic events, such urgent revascularization, (severe) recurrent ischemia, transient attacks, arterial thrombotic events.In PLATelet patient Outcomes (PLATO) study, 18 624 patients presenting with syndromes randomly received ticagrelor (n=9333) or clopidogrel (n=9291). Cox proportional hazard models were used calculate time event ratios. Total compared using a Poisson regression model, second death was calculated Wei Lin Weissfeld method. Patients randomized had 1057 end point versus 1225 for (rate ratio, 0.86; 95% confidence interval, 0.79-0.93; P=0.003). The number additional numerically lower (189 205; P=0.40), resulting in event/death 0.80 (95% 0.70-0.90; P<0.001) needed treat 54. For death/myocardial infarction/stroke/(severe) ischemia/transient attack/arterial fewer (2030 2290; rate 0.88; 0.82-0.95; P<0.001), (740 834; P=0.01) highly significant concurrent reduction 0.83 0.75-0.91; P<0.001). Recurrent PLATO major Thrombolysis Myocardial Infarction (TIMI) non-coronary artery bypass graft bleeding infrequent not different between two therapies (P=0.96 0.38, respectively).In PLATO, treatment resulted including subsequent when clopidogrel. These types analyses demonstrate an even greater absolute benefit over than previously reported.URL: http://www.clinicaltrials.gov/. Unique identifier: NCT00391872.