This article is more than 5 years old. Information may no longer be current.
Vorapaxar reduced late stent thrombosis in patients with stable atherosclerotic vascular disease
Click Here to Manage Email Alerts
Long-term therapy with vorapaxar was associated with reduced risk for definite stent thrombosis in stable patients with atherosclerosis and a history of coronary stenting, according to a new data from the TRA 2P-TIMI 50 trial.
The multinational, randomized, double blind, placebo-controlled study enrolled stable patients with previous MI, peripheral arterial disease or stroke who were assigned vorapaxar (Zontivity, Merck) or placebo. For the new analysis, researchers evaluated rates of definite stent thrombosis using Academic Research Consortium (ARC) criteria.
Of the 26,449 patients randomly assigned vorapaxar or placebo, 14,042 (53%) had a history of coronary stent implantation and 449 patients were implanted with a stent during the trial.
Median follow-up was 2.5 years. During this period, the researchers reported 152 incidences of definite stent thrombosis, 92% of which occurred late or very late.
Compared with placebo, vorapaxar was associated with a reduction in ARC definite stent thrombosis (1.1% vs. 1.4%; HR=0.71; 95% CI, 0.51-0.98). According to the researchers, this reduction remained consistent despite variables including time from PCI, diabetes, use of drug-eluting stents or dual antiplatelet therapy at the time of randomization.
Vorapaxar also yielded increases in GUSTO moderate to severe bleeding (HR=1.57; 95% CI, 1.26-1.94).
“Together, these findings identify PAR-1 as a therapeutic target for reducing the risk of definite stent thrombosis in long-term secondary prevention,” the researchers concluded.
Disclosure: The study was supported by a grant from Merck & Co. See the full study for a list of the researchers’ relevant financial disclosures.
Click Here to Manage Email Alerts