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ACC: Ticagrelor Is Promising Alternative to Clopidogrel

Mortality lower for acute coronary syndrome patients on ticagrelor after CABG

TUESDAY, March 16 (HealthDay News) -- The use of ticagrelor instead of clopidogrel in patients with acute coronary syndrome who undergo coronary artery bypass graft (CABG) surgery is associated with a lower likelihood of fatal outcomes, according to research presented at the Annual Scientific Session of the American College of Cardiology, held from March 14 to 16 in Atlanta.

Claes Held, M.D., of the Uppsala Clinical Research Center in Sweden, and colleagues examined a sub-population of 1,261 patients with acute coronary syndrome who underwent CABG and were part of the Platelet Inhibition and Patient Outcomes (PLATO) trial. For the PLATO trial, patients had been randomized to receive ticagrelor and aspirin or clopidogrel and aspirin.

In line with the results of the overall PLATO trial, the sub-study found that 10.5 percent of patients treated with ticagrelor and aspirin within seven days of CABG had a primary composite end point that included cardiovascular death, heart attack and stroke, compared to 12.6 percent of those treated with clopidogrel and aspirin. In addition, patients undergoing treatment with ticagrelor and aspirin had a lower mortality rate than those taking clopidogrel and aspirin (4.6 percent versus 9.2 percent). The rate of cardiovascular death was also lower in those taking ticagrelor than those taking clopidogrel (4.0 percent versus 7.5 percent). The authors found no statistically significant difference between the two groups for heart attack and stroke, and no significant difference in CABG-related major bleeding.

"Ticagrelor seems to be a very promising alternative to clopidogrel for patients with acute coronary syndrome who might be candidates for CABG surgery, because of the significant reduction in mortality and the similar bleeding rate," Held said in a statement.

The PLATO study was supported by AstraZeneca. One author reported receiving an institutional grant from AstraZeneca, as well as past institutional grants from Schering-Plough, Bristol-Myers Squibb and Sanofi-Aventis.

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