Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/32449
Title: Ticagrelor Versus Clopidogrel in Patients With STEMI Treated With Fibrinolysis TREAT Trial
Authors: BERWANGER, OtavioLOPES, Renato D.MOIA, Diogo D. F.FONSECA, Francisco A.JIANG, LixinGOODMAN, Shaun G.NICHOLLS, Stephen J.PARKHOMENKO, AlexanderAVERKOV, OlegTAJER, CarlosMALAGA, GermanSARAIVA, Jose F. K.GUIMARAES, Helio P.SILVA, Pedro G. M. de Barros eDAMIANI, Lucas P.SANTOS, Renato H. N.PAISANI, Denise M.MIRANDA, Tamiris A.VALEIS, NanciPIEGAS, Leopoldo S.GRANGER, Christopher B.WHITE, Harvey D.NICOLAU, Jose C.
Citation: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, v.73, n.22, p.2819-2828, 2019
Abstract: BACKGROUND The efficacy of ticagrelor in the long-term post-ST-segment elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remains uncertain. OBJECTIVES The purpose of this study was to evaluate the efficacy of ticagrelor when compared with clopidogrel in STEMI patients treated with fibrinolytic therapy. METHODS This international, multicenter, randomized, open-label with blinded endpoint adjudication trial enrolled 3,799 patients (age <75 years) with STEMI receiving fibrinolytic therapy. Patients were randomized to ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) or clopidogrel (300- to 600-mg loading dose, 75 mg daily thereafter). The key outcomes were cardiovascular mortality, myocardial infarction, or stroke, and the same composite outcome with the addition of severe recurrent ischemia, transient ischemic attack, or other arterial thrombotic events at 12 months. RESULTS The combined outcome of cardiovascular mortality, myocardial infarction, or stroke occurred in 129 of 1,913 patients (6.7%) receiving ticagrelor and in 137 of 1,886 patients (7.3%) receiving clopidogrel (hazard ratio: 0.93; 95% confidence interval: 0.73 to 1.18; p = 0.53). The composite of cardiovascular mortality, myocardial infarction, stroke, severe recurrent ischemia, transient ischemic attack, or other arterial thrombotic events occurred in 153 of 1,913 patients (8.0%) treated with ticagrelor and in 171 of 1,886 patients (9.1%) receiving clopidogrel (hazard ratio: 0.88; 95% confidence interval: 0.71 to 1.09; p = 0.25). The rates of major, fatal, and intracranial bleeding were similar between the ticagrelor and clopidogrel groups. CONCLUSION Among patients age <75 years with STEMI, administration of ticagrelor after fibrinolytic therapy did not significantly reduce the frequency of cardiovascular events when compared with clopidogrel. (C) 2019 by the American College of Cardiology Foundation.
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


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