Ticagrelor better than clopidogrel for CABG

Ticagrelor better than clopidogrel for CABG

Ticagrelor better than clopidogrel for CABG: A subgroup analysis of PLATO (Platelet Inhibition and Patient Outcomes) trial, Claes Held, Nils Asenblad, Jean Pierre Bassand, Richard C Becker, Christopher P Cannon, Marc J Claeys, Robert A Harrington, Jay Horrow, Steen Husted, Stefan K James, Kenneth W Mahaffey, José C Nicolau, Benjamin M Scirica, Robert F Storey, Marius Vintila, Joseph Ycas and Lars Wallentin found that in those undergoing coronary artery bypass grafting (CABG) within 7 days after intake of ticagrelor compared with clopidogrel, total and cardiovascular mortality was lower with the former [1]. This result was achieved without an excess bleeding related to CABG. As per study protocol, ticagrelor was withheld 24 to 72 hours and clopidogrel was withheld 5 days before CABG. Of the 18,624 patients with acute coronary syndromes included in the PLATO trial, 1,899 underwent CABG after randomization. Primary composite endpoint of cardiovascular death, myocardial infarction, or stroke was significantly lower with ticagrelor in the whole PLATO trial (P < 0.001). Similar results were obtained in those who underwent CABG as well, with a reduction of primary composite endpoint at 12 months (10.6% vs 13.1%). The total mortality was also lower in the ticagrelor group (4.7% vs 9.7%; P < 0.01) and so was the cardiovascular death (4.1% vs 7.9%; P < 0.01). Ticagrelor is an oral direct-acting P2Y12 receptor antagonist with a reversible receptor binding effect.

Reference

  1. Claes Held, Nils Asenblad, Jean Pierre Bassand, Richard C Becker, Christopher P Cannon, Marc J Claeys, Robert A Harrington, Jay Horrow, Steen Husted, Stefan K James, Kenneth W Mahaffey, José C Nicolau, Benjamin M Scirica, Robert F Storey, Marius Vintila, Joseph Ycas, Lars Wallentin. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial. J Am Coll Cardiol. 2011 Feb 8;57(6):672-84.
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