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Stroke Outcomes Wit...
Stroke Outcomes With Vorapaxar Versus Placebo in Patients With Acute Coronary Syndromes : Insights From the TRACER Trial
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- Ungar, Leo (author)
- Univ Calif Irvine, Dept Cardiol, Med Ctr, Orange, CA 92668 USA
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- Clare, Robert M. (author)
- Duke Clin Res Inst, Dept Med, Durham, NC 27710 USA
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- Rodriguez, Fatima (author)
- Stanford Univ, Div Cardiovasc Med, Sch Med, Stanford, CA USA
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- Kolls, Bradley J. (author)
- Duke Clin Res Inst, Dept Med, Durham, NC 27710 USA
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- Armstrong, Paul W. (author)
- Univ Alberta, Div Cardiol, Edmonton, AB, Canada
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- Aylward, Philip (author)
- Flinders Univ S Australia, South Australian Hlth & Med Res Inst, Adelaide, SA, Australia;Med Ctr, Adelaide, SA, Australia
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- Held, Claes, 1956- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Moliterno, David J. (author)
- Univ Kentucky, Gill Heart Inst, Div Cardiovasc Med, Lexington, KY USA
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- Strony, John (author)
- Johnson & Johnson, New Brunswick, NJ USA
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- Van de Werf, Frans (author)
- Univ Hosp Leuven, Dept Cardiovasc Sci, Leuven, Belgium
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- White, Harvey D. (author)
- Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand
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- Tricoci, Pierluigi (author)
- Duke Clin Res Inst, Dept Med, Durham, NC 27710 USA
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- Harrington, Robert A. (author)
- Stanford Univ, Dept Med, Sch Med, Stanford, CA 94305 USA
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- Mahaffey, Kenneth W. (author)
- Stanford Univ, Dept Med, Sch Med, Stanford, CA 94305 USA
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- Melloni, Chiara (author)
- Duke Clin Res Inst, Dept Med, Durham, NC 27710 USA
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(creator_code:org_t)
- 2018
- 2018
- English.
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In: Journal of the American Heart Association. - 2047-9980. ; 7:24
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Abstract
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- BackgroundVorapaxar, a protease‐activated receptor‐1 antagonist, is approved for secondary prevention of cardiovascular events but is associated with increased intracranial hemorrhage.Methods and ResultsTRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) was a trial of vorapaxar versus placebo among patients with acute coronary syndrome. Strokes were adjudicated by a central events committee. Of 12 944 patients, 199 (1.5%) had ≥1 stroke during the study period (median follow‐up, 477 days). Four patients had a single stroke of unknown type; 195 patients had ≥1 stroke classified as hemorrhagic or nonhemorrhagic (165 nonhemorrhagic, 28 hemorrhagic, and 2 both). Strokes occurred in 96 of 6473 patients (1.5%) assigned vorapaxar and 103 of 6471 patients (1.6%) assigned placebo. Kaplan‐Meier incidence of stroke for vorapaxar versus placebo was higher for hemorrhagic stroke (0.45% versus 0.14% [hazard ratio, 2.74; 95% confidence interval, 1.22–6.15]), lower but not significantly different for nonhemorrhagic stroke (1.53% versus 1.98% at 2 years [hazard ratio, 0.79; 95% confidence interval, 0.58–1.07]), and similar for stroke overall (1.93% versus 2.13% at 2 years [hazard ratio, 0.94; 95% confidence interval, 0.71–1.24]).ConclusionsStroke occurred in <2% of patients. Vorapaxar‐assigned patients had increased hemorrhagic stroke but a nonsignificant trend toward lower nonhemorrhagic stroke. Overall stroke frequency was similar with vorapaxar versus placebo.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- acute coronary syndrome
- stroke
- vorapaxar
Publication and Content Type
- ref (subject category)
- art (subject category)
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Ungar, Leo
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Clare, Robert M.
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Rodriguez, Fatim ...
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Kolls, Bradley J ...
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Armstrong, Paul ...
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Aylward, Philip
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Held, Claes, 195 ...
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Moliterno, David ...
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Strony, John
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Van de Werf, Fra ...
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Wallentin, Lars, ...
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White, Harvey D.
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Tricoci, Pierlui ...
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Harrington, Robe ...
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Mahaffey, Kennet ...
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Melloni, Chiara
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Uppsala University