Author + information
- Kenneth W. Mahaffev,
- Daniel Wojdyla,
- Stefan James,
- Hugo Katus,
- Steen Husted,
- Philippe Steg,
- Christopher Cannon,
- Richard Becker,
- Claes Held,
- Nardev Khurmi,
- Debra Montgomery,
- Anders Himmelmann and
- Robert Harrington
In PLATO, ticagrelor compared with clopidogrel reduced the primary composite endpoint of CV death, MI (excluding silent MI), or stroke in patients with acute coronary syndromes. We explored the effect of ticagrelor on MI, including different types of MI and the impact of event adjudication.
A central clinical events committee (CEC) prospectively defined, systematically identified, and adjudicated MI events.
Overall, 18,624 patients were enrolled in PLATO; 1,097 (Kaplan-Meier % at 1 year: 6.4%) patients had at least one MI identified by the CEC (504 [5.9%] ticagrelor; 593 [6.9%] clopidogrel; HR 0.84; 95°% CI [0.75[[Unable to Display Character: –]]0.95]; P = 0.005), and 975 (5.7%) patients had at least one MI identified by the site investigators (459 [5.3%] ticagrelor; 516 [6.0%] clopidogrel; HR 0.88; 95% CI [0.78[[Unable to Display Character: –]]1.00]; P = 0.052). Table 1shows the MI types reported by the CEC and the site investigators and treatment comparisons. Of the 1,097 MIs reported by the CEC, 681 (62%) were also reported by site investigators, and 416 (38%) were not (205 in ticagrelor group, 211 in clopidogrel group).
In patients with acute coronary syndromes, ticagrelor significantly reduced MI compared with clopidogrel, with consistent results across most MI subtypes. CEC procedures identified more MI endpoints than reported by site investigators.
West, Room 3001
Saturday, March 09, 2013, 8:15 a.m.-8:30 a.m.
Session Title: ACS: New Agents and Approaches
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 901-4
- 2013 American College of Cardiology Foundation