Author + information
- Sameer Bansilal,
- Stephen Wiviott,
- Richard Becker,
- Robert Harrington,
- Anders Himmelmann,
- Benjamin Neely,
- Steen Husted,
- Robert Storey,
- Philippe Steg,
- Hugo Katus,
- Stefan James,
- Lars Wallentin and
- Christopher Cannon
Ticagrelor reduced cardiovascular events and mortality compared to clopidogrel in the PLATO (PLATelet inhibition and patient Outcomes) trial. The use of a glycoprotein IIb/IIIa inhibitor (GPI) is recommended in high–risk patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). We evaluated the efficacy and safety of ticagrelor and clopidogrel with or without GPI use in such patients.
The PLATO trial randomized 18,624 patients with ACS to ticagrelor or clopidogrel, with GPI use per physician discretion. We examined the subgroup of 10,429 patients who underwent PCI within 72 hours. We examined efficacy and safety endpoints at 30 days stratified by GPI use.
A total of 3858 patients (37%) received a GPI during their index hospitalization. Those receiving a GPI were more often younger (59 vs 61 yrs), male (80% vs. 75%), smokers (44% vs. 42%) and underwent multi–vessel PCI (14.6% vs. 12.5%). There was no interaction between treatment and GPI use for the efficacy endpoints (p interaction=0.35 for primary composite outcome). There was also no significant interaction for the safety endpoint of PLATO major bleeding (p interaction= 0.12, Fig. 1).
The effect of ticagrelor compared to clopidogrel on vascular death, myocardial infarction or stroke and PLATO major bleeding was consistent, with or without GPI use, in patients with ACS who underwent PCI.
West, Room 2005
Monday, March 11, 2013, 8:15 a.m.–8:25 a.m.
Session Title: Adjunct Pharmacology
Abstract Category: 39. TCT@ACC–i2: Adjunct Pharmacology
Presentation Number: 2909–3
- 2013 American College of Cardiology Foundation