September 1, 2012Circulation Cardiovascular Quality and Outcomes
Ticagrelor Versus Clopidogrel in Elderly Patients With Acute Coronary Syndromes
Key result
Ticagrelor compared with clopidogrel showed consistent clinical benefit across age groups (interaction P=0.56) without increasing major bleeding in patients ≥75 years (HR 1.02; 95% CI 0.82-1.27).
Why the study?
Does ticagrelor reduce the composite of cardiovascular death, myocardial infarction, or stroke compared to clopidogrel in elderly patients (≥75 years) with acute coronary syndromes?
Population
18,622 patients with acute coronary syndrome from the PLATO trial, stratified by age ≥75 years and <75 years
Comparison
Ticagrelor vs Clopidogrel
Design
RCT
Authors
Discussion
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Implication
Supports ticagrelor over clopidogrel in ACS patients ≥75 years; confirms consistent efficacy and safety across ages in this RCT.
Study Design
Type
RCT (n=18,622)
Structured PICO
Does ticagrelor reduce the composite of cardiovascular death, myocardial infarction, or stroke compared to clopidogrel in elderly patients (≥75 years) with acute coronary syndromes?
P
Population
18,622 patients with acute coronary syndrome from the PLATO trial, analyzed by age subgroups (≥75 and <75 years).
I
Intervention
Ticagrelor
C
Comparator
Clopidogrel
O
Outcome
Composite of cardiovascular death, myocardial infarction, or strokecomposite
Main Result
p-value: p=interaction P=0.56
Ticagrelor maintains its efficacy and safety benefits over clopidogrel in patients with acute coronary syndromes regardless of age, including those ≥75 years.
Cite This Study
Husted et al. (2012) conducted an RCT in Acute Coronary Syndromes (n=18,622). Ticagrelor vs. Clopidogrel was evaluated on composite of cardiovascular death, myocardial infarction, or stroke (p=interaction P=0.56). Ticagrelor compared with clopidogrel showed consistent clinical benefit across age groups (interaction P=0.56) without increasing major bleeding in patients ≥75 years (HR 1.02; 95% CI 0.82-1.27).