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Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery.

Publication ,  Journal Article
Varenhorst, C; Alström, U; Scirica, BM; Hogue, CW; Åsenblad, N; Storey, RF; Steg, PG; Horrow, J; Mahaffey, KW; Becker, RC; James, S; Held, C ...
Published in: Journal of the American College of Cardiology
October 2012

This study investigated the differences in specific causes of post-coronary artery bypass graft surgery (CABG) deaths in the PLATO (Platelet Inhibition and Patient Outcomes) trial.In the PLATO trial, patients assigned to ticagrelor compared with clopidogrel and who underwent CABG had significantly lower total and cardiovascular mortality.In the 1,261 patients with CABG performed within 7 days after stopping study drug, reviewers blinded to treatment assignment classified causes of death into subcategories of vascular and nonvascular, and specifically identified bleeding or infection events that either caused or subsequently contributed to death.Numerically more vascular deaths occurred in the clopidogrel versus the ticagrelor group related to myocardial infarction (14 vs. 10), heart failure (9 vs. 6), arrhythmia or sudden death (9 vs. 3), and bleeding, including hemorrhagic stroke (7 vs. 2). Clopidogrel was also associated with an excess of nonvascular deaths related to infection (8 vs. 2). Among factors directly causing or contributing to death, bleeding and infections were more common in the clopidogrel group compared with the ticagrelor group (infections: 16 vs. 6, p < 0.05, and bleeding: 27 vs. 9, p < 0.01, for clopidogrel and ticagrelor, respectively).The mortality reduction with ticagrelor versus clopidogrel following CABG in the PLATO trial was associated with fewer deaths from cardiovascular, bleeding, and infection complications. (Platelet Inhibition and Patient Outcomes [PLATO]; NCT00391872).

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Published In

Journal of the American College of Cardiology

DOI

EISSN

1558-3597

ISSN

0735-1097

Publication Date

October 2012

Volume

60

Issue

17

Start / End Page

1623 / 1630

Related Subject Headings

  • Treatment Outcome
  • Ticlopidine
  • Ticagrelor
  • Survival Rate
  • Purinergic P2Y Receptor Antagonists
  • Prospective Studies
  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male
  • Humans
 

Citation

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Varenhorst, C., Alström, U., Scirica, B. M., Hogue, C. W., Åsenblad, N., Storey, R. F., … Held, C. (2012). Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery. Journal of the American College of Cardiology, 60(17), 1623–1630. https://doi.org/10.1016/j.jacc.2012.07.021
Varenhorst, Christoph, Ulrica Alström, Benjamin M. Scirica, Charles W. Hogue, Nils Åsenblad, Robert F. Storey, Ph Gabriel Steg, et al. “Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery.Journal of the American College of Cardiology 60, no. 17 (October 2012): 1623–30. https://doi.org/10.1016/j.jacc.2012.07.021.
Varenhorst C, Alström U, Scirica BM, Hogue CW, Åsenblad N, Storey RF, et al. Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery. Journal of the American College of Cardiology. 2012 Oct;60(17):1623–30.
Varenhorst, Christoph, et al. “Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery.Journal of the American College of Cardiology, vol. 60, no. 17, Oct. 2012, pp. 1623–30. Epmc, doi:10.1016/j.jacc.2012.07.021.
Varenhorst C, Alström U, Scirica BM, Hogue CW, Åsenblad N, Storey RF, Steg PG, Horrow J, Mahaffey KW, Becker RC, James S, Cannon CP, Brandrup-Wognsen G, Wallentin L, Held C. Factors contributing to the lower mortality with ticagrelor compared with clopidogrel in patients undergoing coronary artery bypass surgery. Journal of the American College of Cardiology. 2012 Oct;60(17):1623–1630.
Journal cover image

Published In

Journal of the American College of Cardiology

DOI

EISSN

1558-3597

ISSN

0735-1097

Publication Date

October 2012

Volume

60

Issue

17

Start / End Page

1623 / 1630

Related Subject Headings

  • Treatment Outcome
  • Ticlopidine
  • Ticagrelor
  • Survival Rate
  • Purinergic P2Y Receptor Antagonists
  • Prospective Studies
  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male
  • Humans