Long-Term Use of Ticagrelor in Patients with Prior Heart Attack: Ticagrelor Plus Aspirin Versus Aspirin Monotherapy.

Long-Term Use of Ticagrelor in Patients with Prior Heart Attack: Ticagrelor Plus Aspirin Versus Aspirin Monotherapy. Postgrad Med. 2015 Dec 21; Authors: Amico F, Schlesinger A, Mazzoni J Abstract Review of: Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J. 167(4), 437-444.e5 (2014). This Practice Pearl reviews the recent study Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared With Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54). It challenges the current standard of care of 12 months of dual antiplatelet followed by aspirin indefinitely. The study demonstrated that patients who received ticagrelor, either the 60mg or 90mg twice daily plus aspirin, showed a decreased risk of cardiovascular death, myocardial infarction, or stroke. The PEGASUS-TIMI 54 trial also proved that the benefit of ticagrelor was seen early and continued to accrue over time, with a median of 33 months of follow-up, meaning that the benefit persists over time. It is important to note that both doses of the ticagrelor were associated with higher incidence of bleeding, but the rates of fatal bleeding did not show any difference between the ticag...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research