Publication details
Ticagrelor a duální antiagregace po infarktu myokardu - studie PEGASUS
| Title in English | Ticagrelor a dualnf antiagregace po infarktu myokardu - studie PEGASUS |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapie |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | ticagrelor; myocardial infarction; secondary prevention |
| Description | Ticagrelor is a P2Y,2 receptor antagonist that has been shown to reduce ischemic events for up to a year after an acute coronary syndrome in the PLATO trial. The efficacy and safety of long-term ticagrelor therapy beyond 1 year after a myocardial infarction was evaluated in the PEGASUS trial. The trial randomized 21,162 patients with a history of myocardial infarction within the prior 1-3 years in a double--blind 1:1:1 fashion to ticagrelor 90mg twice daily, ticagrelor 60mg twice daily, or placebo, all with low-dose aspirin, and followed them for a median of 33 months. The primary efficacy endpoint was the composite of cardiovascular death, myocardial infarction, or stroke. The primary safety endpoint was TIMI major bleeding. Both doses of ticagrelor significantly reduced the primary efficacy endpoint compared to placebo with Kaplan-Meier rates at 3 years of 7.85% with ticagrelor 90mg BID, 7.77% with ticagrelor 60mg BID, and 9.04% with placebo (HR for ticagrelor 90mg BID vs placebo 0.85, 95% Cl 0.75-0.96, p = 0.0080; HR for ticagrelor 60mg BID vs placebo 0.84, 95% Cl 0.74-0.95, p = 0.0043). Rates of TIMI major bleeding were higher with ticagrelor (2.60% for 90mg BID and 1.06% for placebo, p < 0.001 for each dose against placebo); the rates of intracranial hemorrhage or fatal bleeding were 0.63%, 0.71%, and 0.60% in the 3 arms, respectively (NS). Treatment of patients more than 1 year after a myocardial infarction with ticagrelor reduces the risk of cardiovascular death, myocardial infarction, or stroke, and increases the risk of major bleeding. |