Journal article
Factors Contributing to the Lower Mortality With Ticagrelor Compared With Clopidogrel in Patients Undergoing Coronary Artery Bypass Surgery
Journal of the American College of Cardiology, v 60(17), pp 1623-1630
23 Oct 2012
PMID: 23021325
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
This study investigated the differences in specific causes of post–coronary artery bypass graft surgery (CABG) deaths in the PLATO (Platelet Inhibition and Patient Outcomes) trial.
In the PLATO trial, patients assigned to ticagrelor compared with clopidogrel and who underwent CABG had significantly lower total and cardiovascular mortality.
In the 1,261 patients with CABG performed within 7 days after stopping study drug, reviewers blinded to treatment assignment classified causes of death into subcategories of vascular and nonvascular, and specifically identified bleeding or infection events that either caused or subsequently contributed to death.
Numerically more vascular deaths occurred in the clopidogrel versus the ticagrelor group related to myocardial infarction (14 vs. 10), heart failure (9 vs. 6), arrhythmia or sudden death (9 vs. 3), and bleeding, including hemorrhagic stroke (7 vs. 2). Clopidogrel was also associated with an excess of nonvascular deaths related to infection (8 vs. 2). Among factors directly causing or contributing to death, bleeding and infections were more common in the clopidogrel group compared with the ticagrelor group (infections: 16 vs. 6, p < 0.05, and bleeding: 27 vs. 9, p < 0.01, for clopidogrel and ticagrelor, respectively).
The mortality reduction with ticagrelor versus clopidogrel following CABG in the PLATO trial was associated with fewer deaths from cardiovascular, bleeding, and infection complications. (Platelet Inhibition and Patient Outcomes [PLATO]; NCT00391872)
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Details
- Title
- Factors Contributing to the Lower Mortality With Ticagrelor Compared With Clopidogrel in Patients Undergoing Coronary Artery Bypass Surgery
- Creators
- Christoph Varenhorst - Uppsala UniversityUlrica Alström - Uppsala UniversityBenjamin M. Scirica - Thrombolysis in Myocardial Infarction Study GroupCharles W. Hogue - Johns Hopkins MedicineNils Åsenblad - Uppsala UniversityRobert F. Storey - University of SheffieldPh. Gabriel Steg - Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, FranceJay Horrow - AstraZeneca (United States)Kenneth W. Mahaffey - Clinical Research InstituteRichard C. Becker - Clinical Research InstituteStefan James - Uppsala UniversityChristopher P. Cannon - Brigham and Women's HospitalGunnar Brandrup-Wognsen - AstraZeneca (Sweden)Lars Wallentin - Uppsala UniversityClaes Held - Uppsala University
- Publication Details
- Journal of the American College of Cardiology, v 60(17), pp 1623-1630
- Publisher
- Elsevier
- Grant note
- Bristol-Myers Squibb/Pfizer Bristol-Myers Squibb Schering-Plough/Merck Regado Biotechnologies Eli Lilly & Company Schering Plough Bayer Accumetrics Merck/Schering-Plough MSD AstraZeneca Essentialis Takeda Sanofi Aventis The Medicines Company Gilead Sciences Pozen Novartis Daiichi Sankyo Roche Regeneron GlaxoSmithKline Boehringer-Ingelheim Johnson & Johnson Boehringer Ingelheim Merck
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:000310199700006
- Scopus ID
- 2-s2.0-84867582405
- Other Identifier
- 991020785760704721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems