Long-term ticagrelor therapy in patients with prior myocardial infarction significantly reduces ischaemic events, albeit with increased bleeding

Commentary on: Bonaca MP, Bhatt DL, Cohen M, et al., PEGASUS-TIMI 54 Steering Committee and Investigators. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015;372:1791–800. Context Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist constitute the cornerstone of treatment in patients with acute coronary syndrome (ACS) with a recommended duration of 1 year.1 Nevertheless, high rates of atherothrombotic events, for which platelet activation is heavily implicated, still occur at later stages.2 Therefore, a longer duration of DAPT appears intuitive, albeit with bleeding and cost-effectiveness issues being of particular concern. Methods This was a randomised, double-blind, placebo controlled, multinational trial involving patients >50 years old, with prior myocardial infarction (MI) 1–3 years earlier and one additional high-risk feature including: >65 years, diabetes mellitus, a second prior MI, multivessel coronary artery disease or chronic renal dysfunction. Patients at...

Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Alexopoulos, D. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Therapeutics/Prevention Source Type: research