What question did this study set out to answer?

Evaluate the effect of potent platelet inhibition on total occurrences of primary cardiovascular events after acute coronary syndrome.

January 1, 2013CirculationOpen Access

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

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Key result

Ticagrelor reduced total first and recurrent cardiovascular events compared to clopidogrel in patients with acute coronary syndromes (rate ratio 0.86; 95% CI 0.79-0.93; P=0.003).

Why the study?

Does ticagrelor reduce total (first and recurrent) cardiovascular events compared with clopidogrel in patients with acute coronary syndromes?

Key Points

Evaluate the effect of potent platelet inhibition on total occurrences of primary cardiovascular events after acute coronary syndrome.
Randomly assigned 18624 patients with acute coronary syndromes to receive ticagrelor (n=9333) or clopidogrel (n=9291).
Calculated time to first event and hazard ratios using Cox proportional hazard models.
Compared total events using Poisson regression model and calculated time to second event or death.
Ticagrelor resulted in 1057 total primary endpoint events versus 1225 for clopidogrel (rate ratio, 0.86; 95% CI, 0.79-0.93; P=0.003).
Total cardiovascular events were fewer with ticagrelor (2030 vs 2290; rate ratio, 0.88; 95% CI, 0.82-0.95; P<0.001), indicating a significant clinical benefit.
Hazard for time to second event or death was lower with ticagrelor (0.80; 95% CI, 0.70-0.90; P<0.001).

Structured PICO

Does ticagrelor reduce total (first and recurrent) cardiovascular events compared with clopidogrel in patients with acute coronary syndromes?

Population

18,624 patients presenting with acute coronary syndromes

Intervention

Ticagrelor

Comparator

Clopidogrel

Outcome

Total (first and recurrent) occurrences of any of the primary outcome events (cardiovascular death, myocardial infarction, and stroke)composite

Ticagrelor reduces both first and recurrent cardiovascular events compared with clopidogrel in patients with acute coronary syndromes, demonstrating a greater absolute benefit than previously reported.

Discussion

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Implication

Supports ticagrelor preference over clopidogrel in ACS to cut total event burden; extends first-event data to recurrent outcomes.

Cite This Study

Kohli et al. (2013) studied this question. Ticagrelor reduced total first and recurrent cardiovascular events compared to clopidogrel in patients with acute coronary syndromes (rate ratio 0.86; 95% CI 0.79-0.93; P=0.003).

synapsesocial.com/papers/6a07b41c44ff8ad339f69a7f https://doi.org/10.1161/circulationaha.112.124248

Topics

Dual antiplatelet therapy

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

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

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

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider