Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction

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dc.authoridEmet, Samim/0000-0002-2806-4335
dc.authoridCools, Frank/0000-0001-8883-5368
dc.authoridMagnani, Giulia/0000-0003-1090-0101
dc.authoridFrey, Norbert/0000-0001-7611-378X
dc.authoridUrina-Triana, Miguel A/0000-0001-6003-4622
dc.authoridHidayet, Şıho/0000-0002-4103-9345
dc.authoridBazylevych, Andriy/0000-0001-5053-2548
dc.authorwosidOngen, Zeki/HZL-8534-2023
dc.authorwosidEmet, Samim/AAE-6238-2020
dc.authorwosidMesa, Fredy/E-8730-2016
dc.authorwosidBertolami, Adriana/AAO-4250-2020
dc.authorwosidUrban, Miroslav/JMC-1447-2023
dc.authorwosidCools, Frank/HSF-6823-2023
dc.authorwosidKosmacheva, Elena/AAY-4841-2020
dc.contributor.authorBonaca, Marc P.
dc.contributor.authorBhatt, Deepak L.
dc.contributor.authorCohen, Marc
dc.contributor.authorSteg, Philippe Gabriel
dc.contributor.authorStorey, Robert F.
dc.contributor.authorJensen, Eva C.
dc.contributor.authorMagnani, Giulia
dc.date.accessioned2024-08-04T20:59:54Z
dc.date.available2024-08-04T20:59:54Z
dc.date.issued2015
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBACKGROUND The potential benefit of dual antiplatelet therapy beyond 1 year after a myocardial infarction has not been established. We investigated the efficacy and safety of ticagrelor, a P2Y(12) receptor antagonist with established efficacy after an acute coronary syndrome, in this context. METHODS We randomly assigned, in a double-blind 1: 1: 1 fashion, 21,162 patients who had had a myocardial infarction 1 to 3 years earlier to ticagrelor at a dose of 90 mg twice daily, ticagrelor at a dose of 60 mg twice daily, or placebo. All the patients were to receive low-dose aspirin and were followed for a median of 33 months. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The primary safety end point was Thrombolysis in Myocardial Infarction (TIMI) major bleeding. RESULTS The two ticagrelor doses each reduced, as compared with placebo, the rate of the primary efficacy end point, with Kaplan-Meier rates at 3 years of 7.85% in the group that received 90 mg of ticagrelor twice daily, 7.77% in the group that received 60 mg of ticagrelor twice daily, and 9.04% in the placebo group (hazard ratio for 90 mg of ticagrelor vs. placebo, 0.85; 95% confidence interval [CI], 0.75 to 0.96; P = 0.008; hazard ratio for 60 mg of ticagrelor vs. placebo, 0.84; 95% CI, 0.74 to 0.95; P = 0.004). Rates of TIMI major bleeding were higher with ticagrelor (2.60% with 90 mg and 2.30% with 60 mg) than with placebo (1.06%) (P < 0.001 for each dose vs. placebo); the rates of intracranial hemorrhage or fatal bleeding in the three groups were 0.63%, 0.71%, and 0.60%, respectively. CONCLUSIONS In patients with a myocardial infarction more than 1 year previously, treatment with ticagrelor significantly reduced the risk of cardiovascular death, myocardial infarction, or stroke and increased the risk of major bleeding. (Funded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.)en_US
dc.description.sponsorshipAstraZeneca; PEGASUS-TIMI [54]; Grants-in-Aid for Scientific Research [24390202] Funding Source: KAKENen_US
dc.description.sponsorshipFunded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.en_US
dc.identifier.doi10.1056/NEJMoa1500857
dc.identifier.endpage1800en_US
dc.identifier.issn0028-4793
dc.identifier.issn1533-4406
dc.identifier.issue19en_US
dc.identifier.pmid25773268en_US
dc.identifier.startpage1791en_US
dc.identifier.urihttps://doi.org/10.1056/NEJMoa1500857
dc.identifier.urihttps://hdl.handle.net/11616/103631
dc.identifier.volume372en_US
dc.identifier.wosWOS:000353974700004en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMassachusetts Medical Socen_US
dc.relation.ispartofNew England Journal of Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectEsc Guidelinesen_US
dc.subjectClopidogrelen_US
dc.subjectAspirinen_US
dc.subjectPreventionen_US
dc.subjectManagementen_US
dc.subjectPrasugrelen_US
dc.subjectAngiographyen_US
dc.subjectSecondaryen_US
dc.subjectTherapyen_US
dc.subjectDiseaseen_US
dc.titleLong-Term Use of Ticagrelor in Patients with Prior Myocardial Infarctionen_US
dc.typeArticleen_US

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