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Ticagrelor and Clopidogrel Compared in Heart Patients

Last Updated: January 14, 2010.

Patients awaiting an invasive procedure for acute coronary syndrome have fewer instances of a combined end point of myocardial infarction, stroke or cardiovascular death after treatment with the anti-clotting drug ticagrelor compared to standard care with clopidogrel, according to a study published online Jan. 14 in The Lancet.

THURSDAY, Jan. 14 (HealthDay News) -- Patients awaiting an invasive procedure for acute coronary syndrome have fewer instances of a combined end point of myocardial infarction (MI), stroke or cardiovascular death after treatment with the anti-clotting drug ticagrelor compared to standard care with clopidogrel, according to a study published online Jan. 14 in The Lancet.

Christopher P. Cannon, M.D., of Brigham and Women's Hospital in Boston, and colleagues randomized 13,408 patients hospitalized with acute coronary syndromes (with or without elevated ST), who were slated for an invasive intervention, to six to 12 months of treatment with aspirin and either the reversible and direct-acting oral P2Y12-receptor antagonist ticagrelor and placebo or the thienopyridine clopidogrel and placebo.

At 360 days, the researchers found that fewer patients had experienced the primary study end point (composite of cardiovascular death, MI or stroke) in the ticagrelor group than in the clopidogrel group (event rate 9.0 versus 10.7 percent). No difference was discerned between clopidogrel and ticagrelor for total major bleeding (11.6 versus 11.5 percent) or severe bleeding (3.2 versus 2.9 percent).

"We estimate that use of ticagrelor instead of clopidogrel for one year in 1000 patients with acute coronary syndromes and who are planned to undergo an invasive strategy at the start of drug treatment would lead to 11 fewer deaths, 13 fewer MIs, and six fewer cases of stent thrombosis without an increase in the rates of major bleeding or transfusion," the authors write.

Several study authors reported receiving research grants, consulting fees, lecture fees and advisory board fees from, or owning equity in, pharmaceutical companies, including AstraZeneca, the maker of ticagrelor.

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