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The efficacy of ticagrelor is maintained in women with acute coronary syndromes participating in the prospective, randomized, PLATelet inhibition and patient Outcomes (PLATO) trial
Journal article   Open access   Peer reviewed

The efficacy of ticagrelor is maintained in women with acute coronary syndromes participating in the prospective, randomized, PLATelet inhibition and patient Outcomes (PLATO) trial

Steen Husted, Stefan K James, Richard G Bach, Richard C Becker, Andrzej Budaj, Magda Heras, Anders Himmelmann, Jay Horrow, Hugo A Katus, Riita Lassila, …
European heart journal, v 35(23), pp 1541-1550
14 Jun 2014
DOI: https://doi.org/10.1093/eurheartj/ehu075
PMID: 24682844
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/eurheartj/ehu075View
Published, Version of Record (VoR)CC BY-NC V4.0,  Open

Abstract

Acute Coronary Syndrome - drug therapy Adenosine - administration & dosage Adenosine - adverse effects Adenosine - analogs & derivatives Aged Dose-Response Relationship, Drug Double-Blind Method Female Graft Occlusion, Vascular - prevention & control Hemorrhage - chemically induced Humans Male Myocardial Infarction - etiology Percutaneous Coronary Intervention Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - adverse effects Prospective Studies Purinergic P2Y Receptor Antagonists - administration & dosage Purinergic P2Y Receptor Antagonists - adverse effects Recurrence Sex Factors Stents Stroke - etiology Ticlopidine - administration & dosage Ticlopidine - adverse effects Ticlopidine - analogs & derivatives Treatment Outcome
The aim of this study was to assess the relationship between sex and clinical outcomes and treatment-related complications in patients with ST-elevation or non-ST-elevation acute coronary syndromes (ACS) randomized to treatment with ticagrelor or clopidogrel in the PLATelet inhibition and patient Outcomes (PLATO) trial. The associations between sex subgroup and the primary composite outcomes, secondary outcomes, and major bleeding endpoints as well as interaction of sex subgroup with treatment effects were analysed using Cox proportional-hazards models. Sex was not significantly associated with the probability of the primary composite endpoint [adjusted hazard ratio (HR): 1.02 (0.91-1.16)], or other adverse cardiovascular endpoints. Ticagrelor was similarly more effective than clopidogrel in reducing rates of the primary endpoint in women 11.2 vs. 13.2% [adjusted HR: 0.88 (0.74-1.06)] and men 9.4 vs. 11.1% [adjusted HR: 0.86 (0.76-0.97)] (interaction P-value 0.78), all-cause death in women 5.8 vs. 6.8% [adjusted HR: 0.90 (0.69-1.16)] and men 4.0 vs. 5.7% [adjusted HR: 0.80 (0.67-0.96)] (interaction P-value 0.49), and definite stent thrombosis in women 1.2 vs. 1.4% [adjusted HR: 0.71 (0.36-1.38)] and men 1.4 vs. 2.1% [adjusted HR: 0.63 (0.45-0.89)] (interaction P-value 0.78). The treatments did not differ for PLATO-defined overall major bleeding complications in women [adjusted HR: 1.01 (0.83-1.23)] or men [adjusted HR: 1.10 (0.98-1.24)]. Sex had no significant association with these outcomes (interactions P = 0.43-0.88). Female sex is not an independent risk factor for adverse clinical outcomes in moderate-to-high risk ACS patients. Ticagrelor has a similar efficacy and safety profile in men and women.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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