PLATO study

Introduction

Study characteristics:

• multicenter, double-blind, randomized trial
• 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation
• 12 months duration
• industry-funded

Treatment groups:

• ticagrelor 180 mg loading dose, 90 mg BID thereafter
• clopidogrel 300-600-mg loading dose, 75 mg QD thereafter

Primary end point: a composite of death from vascular causes, myocardial infarction, or stroke

Results:

• primary end point occurred in 9.8% of patients receiving ticagrelor compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84; P<0.001)
• rate of death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel; P<0.001)
• no significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% & 11.2%, respectively; P=0.43)
• ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P=0.03), including more instances of fatal intracranial bleeding but fewer of fatal bleeding of other types

More general terms

• clinical trial