Key result
Ticagrelor was comparable to clopidogrel for the composite of death, MI, and stroke in East Asian patients with AMI (HR 0.97; 95% CI 0.89-1.06; P=0.513), but increased BARC type 2 bleeding.
Why the study?
Ticagrelor improves clinical outcomes in AMI, but its efficacy and safety compared with clopidogrel required evaluation in East Asian patients.
Does ticagrelor reduce the composite of all-cause death, MI, and stroke compared to clopidogrel in East Asian patients with acute myocardial infarction?
Cohort (n=32,442)
Yes
Does ticagrelor reduce the composite of all-cause death, MI, and stroke compared to clopidogrel in East Asian patients with acute myocardial infarction?
Hazard Ratio: 0.97 (95% CI 0.89–1.06)
Absolute Event Rate: 23.6% vs 22.76%
p-value: p=0.513
In East Asian patients with AMI, ticagrelor did not significantly reduce the composite of death, MI, and stroke compared to clopidogrel, but increased the risk of BARC type 2 bleeding while reducing stroke risk.
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Comparable MACE rates with ticagrelor versus clopidogrel; should not change practice and leaves randomized confirmation open.
Chang et al. (2020) conducted a cohort in acute myocardial infarction (n=32,442). Ticagrelor vs. Clopidogrel was evaluated on composite of all-cause death, myocardial infarction (MI), and stroke (HR 0.97, 95% CI 0.89-1.06, p=0.513). Ticagrelor was comparable to clopidogrel for the composite of death, MI, and stroke in East Asian patients with AMI (HR 0.97; 95% CI 0.89-1.06; P=0.513), but increased BARC type 2 bleeding.
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