A new alternative to common thienopyridines has been shown to work through reversible inhibition and is favourable to a broad patient population with acute coronary syndrome (ACS).

Ticagrelor – the first of a new class of platelet-inhibiting agents acting through allosteric binding to the P2Y12 platelet adenosine diphosphate – was superior to clopidogrel in rate reduction of the composite primary endpoint, including cardiovascular (CV) death, myocardial infarction (MI) and stroke, results of the recently concluded PLATO study showed. Principal investigator Dr Lars Wallentin of Sweden elaborated on the implications of the PLATO study results in the late-breaking clinical trials session at the China National Convention Center yesterday.

In the PLATO study, over 18,000 patients with ACS, including both ST-segment elevated MI (STEMI) and non-STEMI ACS, were randomized to receive either ticagrelor or clopidogrel, in addition to aspirin, within 24 hours of initial symptoms for up to 12 months.

Efficacy-wise, ticagrelor demonstrated superiority over clopidogrel in rate reduction of the composite primary endpoint, including CV death, MI and stroke, a difference mostly driven by significant decreases in CV death and MI. This was accompanied by a reduction in stent thrombosis and was associated with a 22% relative reduction in total mortality. These advantages were observed early into the treatment and maintained throughout the duration of therapy.

There was no significant difference in total major bleeding events between clopidogrel and ticagrelor. While dyspnea was reported to be more common in patients who received ticagrelor, it was generally mild to moderate and entirely reversible. In summary, the study results suggest that the overall beneficial effects of ticagrelor compensate for its non-superior safety profile, particularly in high-risk ACS patients.

Session: Platelet inhibition in ACS (Symposium)
Venue: Nile – Level 1 (Ballroom C)
Time: 16:00 – 17:30