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PLATO study
Study characteristics:
- multicenter, double-blind, randomized trial
- 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation
- 12 months duration
- industry-funded
Treatment groups:
1) ticagrelor 180 mg loading dose, 90 mg BID thereafter
2) clopidogrel 300-600-mg loading dose, 75 mg QD thereafter
Primary end point: a composite of death from vascular causes, myocardial infarction, or stroke
Results:
- primary end point occurred in 9.8% of patients receiving ticagrelor compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84; P<0.001)
- rate of death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel; P<0.001)
- no significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% & 11.2%, respectively; P=0.43)
- ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P=0.03), including more instances of fatal intracranial bleeding but fewer of fatal bleeding of other types
General
clinical trial
References
- Wallentin L
Ticagrelor versus Clopidogrel in Patients with Acute Coronary
Syndromes
www.nejm.org August 30, 2009
PMID: 19717846
http://content.nejm.org/cgi/content/full/NEJMoa0904327
- Schomig A
Ticagrelor - Is There Need for a New Player in the
Antiplatelet-Therapy Field?
www.nejm.org August 30, 2009
PMID: 19717845
http://content.nejm.org/cgi/content/full/NEJMe0906549