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Reduction in subtyp...
Reduction in subtypes and sizes of myocardial infarction with ticagrelor in PEGASUS-TIMI 54
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Bonaca, M. P. (author)
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Wiviott, S. D. (author)
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Morrow, D. A. (author)
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show more...
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Steg, P. G. (author)
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Hamm, C. (author)
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Bhatt, D. L. (author)
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Storey, R. F. (author)
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Cohen, M. (author)
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Kuder, J. (author)
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Im, K. (author)
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Magnani, G. (author)
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Budaj, A. (author)
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Nicolau, J. C. (author)
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Parkhomenko, A. (author)
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Sendón, J. L. (author)
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- Dellborg, Mikael, 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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Diaz, R. (author)
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Werf, F. V. D. (author)
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Corbalán, R. (author)
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Goudev, A. (author)
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Jensen, E. C. (author)
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Johanson, P. (author)
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Braunwald, E. (author)
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Sabatine, M. S. (author)
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(creator_code:org_t)
- 2018
- 2018
- English.
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In: Journal of the American Heart Association. - 2047-9980. ; 7:22
- Related links:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background-—Ticagrelor reduced cardiovascular death, myocardial infarction (MI), or stroke in patients with prior MI in PEGASUSTIMI 54 (Prevention of Cardiovascular Events [eg, Death From Heart or Vascular Disease, Heart Attack, or Stroke] in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin). MI can occur in diverse settings and with varying severity; therefore, understanding the types and sizes of MI events prevented is of clinical importance. Methods and Results-—MIs were adjudicated by a blinded clinical events committee and categorized by subtype and fold elevation of peak cardiac troponin over the upper limit of normal. A total of 1042 MIs occurred in 898 of the 21 162 randomized patients over a median follow-up of 33 months. The majority of the MIs (76%) were spontaneous (Type 1), with demand MI (Type 2) and stent thrombosis (Type 4b) accounting for 13% and 9%, respectively; sudden death (Type 3), percutaneous coronary intervention–related (Type 4a) and coronary artery bypass graft–related (Type 5) each accounted for <1%. Half of MIs (520, 50%) had a peak troponin ≥10x upper limit of normal and 21% of MIs (220) had a peak troponin ≥1009 upper limit of normal. A total of 21% (224) were ST-segment–elevation MI STEMI. Overall ticagrelor reduced MI (4.47% versus 5.25%, hazard ratio 0.83, 95% confidence interval 0.72–0.95, P=0.0055). The benefit was consistent among the subtypes, including a 31% reduction in MIs with a peak troponin ≥1009 upper limit of normal (hazard ratio 0.69, 95% confidence interval 0.53–0.92, P=0.0096) and a 40% reduction in ST-segment elevation MI (hazard ratio 0.60, 95% confidence interval 0.46–0.78, P=0.0002). Conclusions-—In stable outpatients with prior MI, the majority of recurrent MIs are spontaneous and associated with a high biomarker elevation. Ticagrelor reduces the MI consistently among subtypes and sizes including large MIs and ST-segment elevation MI. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique identifier: NCT01225562. © 2018 The Authors.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Antiplatelet therapy
- Myocardial infarction
- ST-segment elevation myocardial infarction
- Ticagrelor
- Troponin
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Bonaca, M. P.
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Wiviott, S. D.
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Morrow, D. A.
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Steg, P. G.
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Hamm, C.
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Bhatt, D. L.
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show more...
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Storey, R. F.
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Cohen, M.
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Kuder, J.
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Im, K.
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Magnani, G.
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Budaj, A.
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Nicolau, J. C.
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Parkhomenko, A.
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Sendón, J. L.
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Dellborg, Mikael ...
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Diaz, R.
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Werf, F. V. D.
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Corbalán, R.
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Goudev, A.
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Jensen, E. C.
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Johanson, P.
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Braunwald, E.
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Sabatine, M. S.
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show less...
- About the subject
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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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Journal of the A ...
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University of Gothenburg