1 / 7

PLATO: a study of PLATelet inhibition and patient Outcomes

britannia
Download Presentation

PLATO: a study of PLATelet inhibition and patient Outcomes

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. PLATO: a study of PLATelet inhibition and patient Outcomes Purpose To compare ticagrelor, an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12, with clopidogrel for the prevention of cardiovascular events in patients admitted to hospital with an acute coronary syndrome, with or without ST-segment elevation. Reference Wallentin L, Becker RC, Budaj A, et al. for the PLATO Investigators. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009;361:1045–1057.

    2. PLATO: a study of PLATelet inhibition and patient Outcomes - TRIAL DESIGN - Design International, multicenter, double-blind, randomized trial. Patients 18,624 patients admitted to hospital with acute coronary syndrome, with or without ST-segment elevation, within 24 hours of symptom onset. Patients with acute ST-segment elevation were scheduled for primary percutaneous coronary intervention; patients without ST-segment elevation were managed invasively or medically. Follow-up and primary endpoint The primary efficacy endpoint was a composite of death from vascular causes, myocardial infarction or stroke; the primary safety endpoint was major bleeding; patients were followed up to 12 months. Treatment Ticagrelor 180 mg loading dose and 90 mg twice daily thereafter or clopidogrel 300–600 mg loading dose and 75 mg daily thereafter; treatment exposure: 6–12 months.

    3. PLATO: a study of PLATelet inhibition and patient Outcomes - TRIAL DESIGN continued -

    4. PLATO: a study of PLATelet inhibition and patient Outcomes - RESULTS - Primary endpoint and follow-up The primary endpoint of death from vascular causes, myocardial infarction or stroke occurred in 9.8% of patients receiving ticagrelor compared with 11.7% of those receiving clopidogrel. The hazard ratio (HR) for the primary efficacy endpoint was 0.84 for ticagrelor versus clopidogrel (p=0.0003). Secondary endpoints Ticagrelor was associated with significant reductions in the incidence of several secondary endpoints, including death from vascular causes, myocardial infarction and all-cause mortality. Safety endpoints The incidence of major bleeding, a primary safety endpoint, did not differ between the ticagrelor and clopidogrel groups (11.6% vs 11.2%, respectively; HR, 1.04; p=0.43). Other results Ticagrelor was associated with a higher rate of major bleeding not related to coronary artery bypass grafting (4.5% vs 3.8% for clopidogrel; p=0.03), including more instances of fatal intracranial bleeding and fewer fatal bleeds of other types.

    5.

    7. PLATO: a study of PLATelet inhibition and patient Outcomes - RESULTS continued -

    8. PLATO: a study of PLATelet inhibition and patient Outcomes - SUMMARY - In patients with an acute coronary syndrome, with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction or stroke. No increase in the rate of overall major bleeding was observed in these patients; however, there was an increase in the rate of non-procedure-related bleeding.

More Related