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@article{1334843,
author = {Bonaca, M.P. and Bhatt, D.L. and Cohen, M. and Steg, P.G. and Storey, R.F. and Jensen, E.C. and Magnani, G. and Bansilal, S. and Fish, M.P. and Im, K. and Bengtsson, O. and Ophuis, T.O. and Budaj, A. and Theroux, P. and Ruda, M. and Hamm, C. and Goto, S. and Špinar, Jindřich and Nicolau, J.C. and Kiss, R.G. and Murphy, S. and Wiviott, S.D. and Held, P. and Braunwald, E. and Sabatine, MS},
article_location = {Waltham},
article_number = {19},
doi = {http://dx.doi.org/10.1056/NEJMoa1500857},
keywords = {Ticagrelor; Prior Myocardial Infarction},
language = {eng},
issn = {0028-4793},
journal = {New England Journal of Medicine},
title = {Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction},
volume = {372},
year = {2015}
}
TY - JOUR
ID - 1334843
AU - Bonaca, M.P. - Bhatt, D.L. - Cohen, M. - Steg, P.G. - Storey, R.F. - Jensen, E.C. - Magnani, G. - Bansilal, S. - Fish, M.P. - Im, K. - Bengtsson, O. - Ophuis, T.O. - Budaj, A. - Theroux, P. - Ruda, M. - Hamm, C. - Goto, S. - Špinar, Jindřich - Nicolau, J.C. - Kiss, R.G. - Murphy, S. - Wiviott, S.D. - Held, P. - Braunwald, E. - Sabatine, MS
PY - 2015
TI - Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction
JF - New England Journal of Medicine
VL - 372
IS - 19
SP - 1791-1800
EP - 1791-1800
PB - Massachussetts Medical Society
SN - 00284793
KW - Ticagrelor
KW - Prior Myocardial Infarction
N2 - BACKGROUND 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.
ER -
BONACA, M.P., D.L. BHATT, M. COHEN, P.G. STEG, R.F. STOREY, E.C. JENSEN, G. MAGNANI, S. BANSILAL, M.P. FISH, K. IM, O. BENGTSSON, T.O. OPHUIS, A. BUDAJ, P. THEROUX, M. RUDA, C. HAMM, S. GOTO, Jindřich ŠPINAR, J.C. NICOLAU, R.G. KISS, S. MURPHY, S.D. WIVIOTT, P. HELD, E. BRAUNWALD a MS SABATINE. Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction. \textit{New England Journal of Medicine}. Waltham: Massachussetts Medical Society, 2015, roč.~372, č.~19, s.~1791-1800. ISSN~0028-4793. Dostupné z: https://dx.doi.org/10.1056/NEJMoa1500857.
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