Ticagrelor vs Clopidogrel After Fibrinolytic Therapy in Patients With ST-Elevation Myocardial Infarction

Abstract

clinicaltrials.gov Identifier: NCT02298088.

Lo mejor del Congreso ACC 2018

“…El estudio TREAT comparó la seguridad a corto plazo de ticagrelor frente a clopidogrel en pacientes menores de 75 años que presentaron infarto agudo de miocardio con elevación del segmento ST (IAMcEST) tratados con fibrinolíticos. El objetivo primario fue valorar el sangrado mayor, según los criterios TIMI, en los primeros 30 días (19,20) .…”

The Role of Ticagrelor in STEMI Fibrinolytic and Its Rationale to Utilize for Indonesian Patients

“…Patients were randomly assigned to receive Ticagrelor or Clopidogrel as early as possible after the index event and not more than 24 hours after the event. 9 At 30 days, TIMI major bleeding had occured in 14 of 1913 patients (0,73%) receiving Ticagrelor and in 13 of 1886 patients (0,69%) receiving Clopidogrel (absolute difference 0,04%; 95% CI -0,49% to 0,58%; p<0,001 for non-inferiority). Major bleeding defined by the PLATO criteria and by the Bleeding Academic Research Consortium (BARC) types 3 to 5 bleeding was similarly showed non-inferiority.…”

“…Thus TREAT trial was conducted to evaluate the safety of Ticagrelor in this clinical setting. 9 This multicenter, randomized, open-label with blinded end point adjudication trial, involving 3799 patients with STEMI receiving fibrinolytic therapy from 10 countries. The follow-up period is 30-day.…”

“…This study concluded that in patients younger than 75 years with STEMI, delayed administration of Ticagrelor after fibrinolytic therapy was noninferior to Clopidogrel for TIMI major bleeding at 30 days. 9 TREAT study was not powered to assess efficacy outcomes, therefore the efficacy result must be interpreted as exploratory. This trial also not address treatment of patients older than 75 years, who were excluded.…”

“…This trial also not address treatment of patients older than 75 years, who were excluded. 9 Several experts in cardiology in Indonesia have discussed the TREAT study design and its preliminary 30 days results in order to generate the rationale position of Ticagrelor in STEMI thrombolysis treatment which in-line with daily clinical practice in Indonesia. The Indonesian Journal of Cardiology meeting concluded that PLATO study is the cornerstone of Ticagrelor efficacy in ACS patients and the TREAT study (30 days results) provides evidence that Ticagrelor is as safe as Clopidogrel in STEMI patients after treated with fibrinolytic.…”