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Ticagrelor compared favorably with clopidogrel in stent thrombosis reduction
Data from the PLATO trial indicate that ticagrelor reduces the incidence of stent thrombosis more often than clopidogrel in a broad range of patients, stent types and treatment regimens.
Researchers of the study, published in Circulation, performed a subgroup analysis of data on 18,624 patients from the PLATO trial. All patients had ACS and 11,289 had at least one intracoronary stent.
Compared with clopidogrel (Plavix, Sanofi-Aventis), ticagrelor (Brilinta, AstraZeneca) reduced the incidence of stent thrombosis across all definitions: definite (1.37% vs. 1.93%); definite or probable (2.21% vs. 2.87%); and definite, probable or possible (2.94% vs. 3.77%).
P. Gabriel Steg
“The benefit of ticagrelor in reducing definite stent thrombosis appeared independent of baseline variables, such as ACS, diabetes, geographic region of enrollment, clopidogrel CYP2C19 genotype, pre-randomization dose of aspirin and clopidogrel and stent type (bare metal or drug eluting),” P. Gabriel Steg, MD, director of the coronary care unit at the Hôpital Bichat-Claude Bernard, Paris, and researchers wrote.
Although there was no statistical difference in acute stent thrombosis (<24 hours; HR=0.94; 95% CI, 0.43-2.05) between groups, both subacute (24 hours-30 days; HR=0.60; 95% CI; 0.39-0.93) and late (>30 days; HR=0.48; 95% CI 0.24-0.96) stent thrombosis were markedly reduced with ticagrelor.
Disclosure: The PLATO trial was funded by AstraZeneca. See the study for a full list of researcher disclosures.