Key result
Vorapaxar reduced overall occurrences of ischemic events compared to placebo (HR 0.88; 95% CI 0.80-0.98; P=0.02) but increased moderate and severe bleeding (HR 1.42; 95% CI 1.21-1.66; P<0.001).
Why the study?
Does vorapaxar reduce overall occurrences of ischemic events in patients with non-ST-segment elevation acute coronary syndromes?
RCT (n=12,944)
randomized
Does vorapaxar reduce overall occurrences of ischemic events in patients with non-ST-segment elevation acute coronary syndromes?
Hazard Ratio: 0.88 (95% CI 0.8–0.98)
Number Needed to Treat: 51
p-value: p=0.02
In patients with non-ST-segment elevation acute coronary syndromes, vorapaxar reduces the overall burden of recurrent ischemic events but significantly increases the risk of moderate and severe bleeding.
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Vorapaxar may reduce recurrent ischemic events in ACS despite higher bleeding; extends evidence to total event burden in secondary prevention.
White et al. (2014) conducted an RCT in non-ST-segment elevation acute coronary syndromes (n=12,944). vorapaxar vs. placebo was evaluated on overall occurrences of ischemic events, first and subsequent (HR 0.88, 95% CI 0.80 to 0.98, p=0.02). Vorapaxar reduced overall occurrences of ischemic events compared to placebo (HR 0.88; 95% CI 0.80-0.98; P=0.02) but increased moderate and severe bleeding (HR 1.42; 95% CI 1.21-1.66; P<0.001).
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