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Ticagrelor in patie...
Ticagrelor in patients with heart failure after acute coronary syndromes - Insights from the PLATelet inhibition and patient Outcomes (PLATO) trial
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- Åkerblom, Axel, 1977- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Wojdyla, Daniel M. (author)
- Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- James, Stefan, 1964- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Brito, Flavio de Souza (author)
- Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
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- Steg, Philippe Gabriel (author)
- Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France;Paris Diderot Univ, Sorbonne Paris Cite, Paris, France;NHLI Imperial Coll, ICMS, Royal Brampton Hosp, London, England;FACT, FCRIN Network, INSERM U1148, Paris, France
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- Cannon, Christopher P. (author)
- Brigham & Womens Hosp, Cardiovasc Div, 75 Francis St, Boston, MA 02115 USA
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- Katus, Hugo A. (author)
- Univ Klinikum, Med Klin, Heidelberg, Germany
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- Himmelmann, Anders (author)
- AstraZenca Res & Dev, Gothenburg, Sweden
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- Storey, Robert F. (author)
- Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England
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- Becker, Richard C. (author)
- Acad Hlth Ctr, Div Cardiovasc Hlth & Dis, Heart Lung & Vasc Inst, Cincinnati, OH USA
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- Lopes, Renato D. (author)
- Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
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(creator_code:org_t)
- MOSBY-ELSEVIER, 2019
- 2019
- English.
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In: American Heart Journal. - : MOSBY-ELSEVIER. - 0002-8703 .- 1097-6744. ; 213, s. 57-65
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Heart failure (HF) following acute coronary syndromes (ACS) is associated with worse prognosis; however, the efficacy and safety of ticagrelor in patients with HF and if ticagrelor influences the risk of new-onset HF are unknown.Methods: We examined the efficacy and safety of ticagrelor compared to clopidogrel in patients with ACS in the randomized PLATelet inhibition and patient Outcomes (PLATO) trial subdivided by strata: (1) previous HF and/or clinical signs of HF on admission or (2) no HF on admission. The primary outcome was the combination of cardiovascular death, myocardial infarction, or stroke evaluated by multivariable Cox regression models. The safety outcome was major bleeding. New-onset HF was defined as an HF event after discharge in patients without previous HF.Results: Data were available in 18,556 patients, whom 2,862 (15.4%) patients had HF, including 1,584 (8.5%) patients with previous HF. Patients randomized to ticagrelor had lower risk of the composite end point regardless of HF status: hazard ratio (HR) 0.87 (95% CI: 0.73-1.03) in patients with HF and HR 0.84 (95% CI: 0.75-0.93) in patients with no HF (P = .76). Corresponding HR for major bleeding were HR 1.08 (95% CI: 0.87-1.34) and HR 1.03 (95% CI: 0.94-1.14) (P = .71). There was no difference in new-onset HF at 12 months between patients randomized to ticagrelor (4.1%, n = 278) or clopidogrel (4.0%, n = 276).Conclusions: In patients with ACS, ticagrelor is more efficacious in protecting against new ischemic events and mortality than clopidogrel irrespective of the presence of HF. There is no difference between ticagrelor or clopidogrel treatment in new-onset HF post-ACS.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- ref (subject category)
- art (subject category)
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Åkerblom, Axel, ...
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Wojdyla, Daniel ...
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Wallentin, Lars, ...
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James, Stefan, 1 ...
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Brito, Flavio de ...
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Steg, Philippe G ...
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Cannon, Christop ...
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Katus, Hugo A.
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Himmelmann, Ande ...
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Storey, Robert F ...
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Becker, Richard ...
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Lopes, Renato D.
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- MEDICAL AND HEALTH SCIENCES
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American Heart J ...
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Uppsala University