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Ticagrelor Versus C...
Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease : An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial
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- Andell, Pontus (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- James, Stefan K. (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
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- Cannon, Christopher P. (author)
- Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA.;Harvard Clin Res Inst, Boston, MA USA.,Brigham and Women's Hospital / Harvard Medical School
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- Cyr, Derek D. (author)
- Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA.,Duke University
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- Himmelmann, Anders (author)
- AstraZeneca Res & Dev, Molndal, Sweden.
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- Husted, Steen (author)
- Hosp Unit West, Dept Med, Herning Holstebro, Denmark.,Regional Hospital Unit West Jutland
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- Keltai, Matyas (author)
- Semmelweis Univ, Hungarian Inst Cardiol, H-1085 Budapest, Hungary.,Semmelweis University
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- Koul, Sasha (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Santoso, Anwar (author)
- Univ Indonesia, Natl Cardiovasc Ctr, Harapan Kita Hosp, Dept Cardiol,Vasc Med,Fac Med, Jakarta, Indonesia. INSERM, U1148, Paris, France. Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, F-75877 Paris, France. Univ Paris Diderot, Sorbonne Paris Cite, Paris, France. Royal Brompton Hosp, ICMS, NHLI Imperial Coll, London SW3 6LY, England.,University of Indonesia
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- Steg, Gabriel (author)
- Royal Brompton Hospital
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- Storey, Robert F. (author)
- Univ Sheffield, Dept Cardiovasc Sci, Sheffield S10 2TN, S Yorkshire, England.,University of Sheffield
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- Wallentin, Lars (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala University Hospital
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- Erlinge, David (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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(creator_code:org_t)
- 2015
- 2015
- English.
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In: Journal of the American Heart Association. - 2047-9980. ; 4:10
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Background-Patients with chronic obstructive pulmonary disease (COPD) experiencing acute coronary syndromes (ACS) are at high risk for clinical events. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor versus clopidogrel reduced the primary endpoint of death from vascular causes, myocardial infarction, or stroke after ACS, but increased the incidence of dyspnea, which may lead clinicians to withhold ticagrelor from COPD patients. Methods and Results-In 18 624 patients with ACS randomized to treatment with ticagrelor or clopidogrel, history of COPD was recorded in 1085 (5.8%). At 1 year, the primary endpoint occurred in 17.7% of patients with COPD versus 10.4% in those without COPD (P<0.001). The 1-year event rate for the primary endpoint in COPD patients treated with ticagrelor versus clopidogrel was 14.8% versus 20.6% (hazard ratio [HR]=0.72; 95% confidence interval [CI]: 0.54 to 0.97), for death from any cause 8.4% versus 12.4% (HR=0.70; 95% CI: 0.47 to 1.04), and for PLATO-defined major bleeding rates at 1 year 14.6% versus 16.6% (HR=0.85; 95% CI: 0.61 to 1.17). Dyspnea occurred more frequently with ticagrelor (26.1% vs. 16.3%; HR=1.71; 95% CI: 1.28 to 2.30). There was no differential increase in the relative risk of dyspnea compared to non-COPD patients (HR=1.85). No COPD status-by-treatment interactions were found, showing consistency with the main trial results. Conclusions-In this post-hoc analysis, COPD patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in COPD patients, without increasing overall major bleeding events. The benefit-risk profile supports the use of ticagrelor in patients with ACS and concomitant COPD.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- cardiovascular diseases
- lung
- myocardial infarction
- Cardiovascular diseases
- Lung
- Myocardial infarction
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Andell, Pontus
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James, Stefan K.
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Cannon, Christop ...
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Cyr, Derek D.
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Himmelmann, Ande ...
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Husted, Steen
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show more...
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Keltai, Matyas
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Koul, Sasha
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Santoso, Anwar
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Steg, Gabriel
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Storey, Robert F ...
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Wallentin, Lars
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Erlinge, David
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- 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 ...
- Articles in the publication
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Journal of the A ...
- By the university
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Uppsala University
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Lund University