The efficacy of ticagrelor is maintained in women with acute coronary syndromes participating in the prospective, randomized, PLATelet inhibition and patient Outcomes (PLATO) trial

Autor: Husted, S, James, SK, Bach, RG, Becker, RC, Budaj, A, Heras, M, Himmelmann, A, Horrow, J, Katus, HA, Lassila, R, Morais, J, Nicolau, JC, Steg, PG, Storey, RF, Wojdyla, D, Wallentin, L, PLATO study group
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
Ticagrelor
Adenosine
Myocardial Infarction
Recurrence
Clinical endpoint
Medicine
Cardiac and Cardiovascular Systems
Myocardial infarction
Prospective Studies
Kardiologi
Hazard ratio
Graft Occlusion
Vascular
Clopidogrel
3. Good health
Stroke
Treatment Outcome
Female
Stents
Sex
Cardiology and Cardiovascular Medicine
medicine.drug
Platelets
medicine.medical_specialty
Ticlopidine
Hemorrhage
Acute coronary syndromes
Percutaneous Coronary Intervention
Sex Factors
Double-Blind Method
Clinical Research
Internal medicine
Humans
Risk factor
Acute Coronary Syndrome
Aged
Dose-Response Relationship
Drug
business.industry
Surrogate endpoint
Unstable angina
Klinisk medicin
Thrombosis
P2Y(12) receptor
medicine.disease
Surgery
Purinergic P2Y Receptor Antagonists
P2Y12 receptor
Clinical Medicine
business
Acute Coronary Syndromes
Platelet Aggregation Inhibitors
Zdroj: European Heart Journal
Popis: Aims The aim of this study was to assess the relationship between sex and clinical outcomes and treatment-related complications in patients with ST-elevation or non-ST-elevation acute coronary syndromes (ACS) randomized to treatment with ticagrelor or clopidogrel in the PLATelet inhibition and patient Outcomes (PLATO) trial. Methods The associations between sex subgroup and the primary composite outcomes, secondary outcomes, and major bleeding endpoints as well as interaction of sex subgroup with treatment effects were analysed using Cox proportional-hazards models. Results Sex was not significantly associated with the probability of the primary composite endpoint \[adjusted hazard ratio (HR): 1.02 (0.91−1.16)], or other adverse cardiovascular endpoints. Ticagrelor was similarly more effective than clopidogrel in reducing rates of the primary endpoint in women 11.2 vs. 13.2% [adjusted HR: 0.88 (0.74−1.06)] and men 9.4 vs. 11.1% [adjusted HR: 0.86 (0.76−0.97)\] (interaction P -value 0.78), all-cause death in women 5.8 vs. 6.8% \[adjusted HR: 0.90 (0.69−1.16)] and men 4.0 vs. 5.7% [adjusted HR: 0.80 (0.67−0.96)\] (interaction P -value 0.49), and definite stent thrombosis in women 1.2 vs. 1.4% \[adjusted HR: 0.71 (0.36−1.38)] and men 1.4 vs. 2.1% [adjusted HR: 0.63 (0.45−0.89)\] (interaction P -value 0.78). The treatments did not differ for PLATO-defined overall major bleeding complications in women [adjusted HR: 1.01 (0.83−1.23)] or men [adjusted HR: 1.10 (0.98−1.24)]. Sex had no significant association with these outcomes (interactions P = 0.43−0.88). Conclusion Female sex is not an independent risk factor for adverse clinical outcomes in moderate-to-high risk ACS patients. Ticagrelor has a similar efficacy and safety profile in men and women.
Databáze: OpenAIRE
Externí odkaz: