17 Jun The PLATelet inhibition and patient Outcomes (PLATO) trial found that the reversibly binding oral P2Yinhibitor ticagrelor was superior to. 25 Oct The Platelet Inhibition and Patient Outcomes (PLATO) trial compared the use of ticagrelor, a newer and more potent oral platelet inhibitor, with. BRILINTA has been proven superior to clopidogrel in reducing thrombotic CV events at 12 months in the PLATO trial, studying STEMI (ST-elevation myocardial .

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The PLATelet inhibition and patient Outcomes PLATO trial found that the reversibly binding oral P2Yinhibitor ticagrelor was superior to clopidogrel for the prevention of the composite end point of death from vascular causes, myocardial infarction, and stroke, as well as vascular death in itself and total death, without an increase in major bleeding, in a broad population of patients with acute coronary syndromes starting treatment as soon as possible after hospital admission.

All patients received acetylsalicylic acid aspirin unless they were intolerant of it. Outcomes The incidence of the primary composite end point was significantly lower with ticagrelor than with clopidogrel After one year administer 60 mg twice daily. We used univariable Cox proportional hazards models to analyse the primary and secondary end point results. Previous intracranial hemorrhage Gastrointestinal bleeding within 6 months Known bleeding diathesis or coagulation disorder or required treatment with anticoagulants.

Circulation ; Ticagrelor versus clopidogrel in patients with acute coronary syndromes.

PLATO study of ticagrelor versus clopidogrel in patients with high-risk acute coronary syndromes.

Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: We found a significantly higher incidence of PLATO defined other major bleedings and of the composite of major and minor bleedings in the ticagrelor group owing to a higher incidence of bleedings related to non-coronary artery bypass grafting during long term treatment.

Patients with ticagrelkr significant disease had numerically lower event rates compared with those who were discovered to have significant disease. Strong inhibitors substantially increase ticagrelor exposure and so increase the risk of adverse events. Despite an intended non-invasive strategy at the time of randomisation, approximately half of the patients had coronary angiography, a third had percutaneous coronary intervention, and one tenth had coronary artery bypass grafting during the course of the study for emerging clinical indications.

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Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management: Nor did we find any significant difference between the randomised groups when we used the TIMI definition of major bleeding. Views Read View source View history. Death from vascular causes included cardiovascular deaths, cerebrovascular deaths, or any other death for which no non-vascular cause was clearly documented.

Randomisation and interventions Patients were randomly assigned to ticagrelor or clopidogrel.

Compare with Clopidogrel – BRILINTA┬« (ticagrelor) tablets | For HCPs

While there was no difference in major bleeding, ticagrelor was associated with more non-CABG-related bleeding 4. Previous intracranial hemorrhage, gastrointestinal bleeding within 6 months, poato bleeding diathesis or coagulation disorder, or required treatment with anticoagulants. Am Heart J ; Skip to main content.

Introduction In patients with non-ST elevation acute coronary syndrome with moderate to high risk characteristics, current guidelines recommend an invasive strategy with angiography followed by percutaneous coronary intervention or coronary artery bypass grafting if appropriate.

These findings are consistent with registry data and post hoc analyses from clinical trials showing an up to twofold higher event rate compared with patients who have revascularisation.

The New England Journal of Medicine. View data in patients with a history of MI.

The irreversible effects of both thienopyridines is thought to account for the increased bleeding from major surgical procedures including CABG, [1] and thus investigators sought an antiplatelet agent with different pharmacokinetics. Subgroup analyses were performed to evaluate consistency of results in different cohorts.

All patients gave a written informed consent. What this study adds In acute coronary syndrome patients initially intended for non-invasive management, ticagrelor achieved a clinically important reduction in ischaemic events and mortality compared with clopidogrel, without increasing major bleeding The reduction of ischaemic events and mortality by ticagrelor over clopidogrel was consistent in acute coronary syndrome patients with non-ST elevation who did not actually have revascularisation The benefits of intensified P2Y12 inhibition apply across different management strategies.


PLATO – Wiki Journal Club

At the time of randomisation, the treating physician designated patients as planned for initial invasive management or initial conservative management in the interactive voice randomisation system. Comparison of ticagrelor, the first reversible oral P2Y 12 receptor antagonist, with clopidogrel in patients with acute coronary syndromes: Despite the initial intent for a non-invasive approach, This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

Primary end point Real-world study limitations. Navigation menu Personal tools Create account Log in. The median age was 65 years, and Treatments and procedures during hospital admission.

Efficacy and safety of abciximab on acute myocardial infarction treated with percutaneous coronary interventions: Administer 90 mg twice daily during the first year after an ACS event. Review additional safety data from the real-world patient registry.


Retrieved from ” http: We also found a numerical increase in intracerebral bleedings, although the numbers were very small. For ticahrelor least the first 12 months following ACS, it is superior to clopidogrel. Compared to clopidogrel, ticagrelor significantly reduced the rate of CV death, MI, or stroke without an increase in the rate of overall major bleeding.