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Statements

Subject Item
n2:RIV%2F00843989%3A_____%2F09%3A00103114%21RIV13-MZ0-00843989
rdf:type
n12:Vysledek skos:Concept
dcterms:description
Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and more pronounced platelet inhibition than clopidogrel. In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation. At 12 months, the primary end point - a composite of death from vascular causes, myocardial infarction, or stroke - had occurred in 9.8% of patients receiving ticagrelor as compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84; 95% confidence interval [CI], 0.77 to 0.92; P<0.001). Predefined hierarchical testing of secondary end points showed significant differences in the rates of other composite end points, as well as myocardial infarction alone (5.8% in the ticagrelor group vs. 6.9% in the clopidogrel group, P = 0.005) and death from vascular causes (4.0% vs. 5.1%, P = 0.001) but not stroke alone (1.5% vs. 1.3%, P = 0.22). The rate of death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel; P<0.001). No significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% and 11.2%, respectively; P = 0.43), but ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P = 0.03), including more instances of fatal intracranial bleeding and fewer of fatal bleeding of other types. In patients who have an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke without an increase in the rate of overall major bleeding... Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and more pronounced platelet inhibition than clopidogrel. In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation. At 12 months, the primary end point - a composite of death from vascular causes, myocardial infarction, or stroke - had occurred in 9.8% of patients receiving ticagrelor as compared with 11.7% of those receiving clopidogrel (hazard ratio, 0.84; 95% confidence interval [CI], 0.77 to 0.92; P<0.001). Predefined hierarchical testing of secondary end points showed significant differences in the rates of other composite end points, as well as myocardial infarction alone (5.8% in the ticagrelor group vs. 6.9% in the clopidogrel group, P = 0.005) and death from vascular causes (4.0% vs. 5.1%, P = 0.001) but not stroke alone (1.5% vs. 1.3%, P = 0.22). The rate of death from any cause was also reduced with ticagrelor (4.5%, vs. 5.9% with clopidogrel; P<0.001). No significant difference in the rates of major bleeding was found between the ticagrelor and clopidogrel groups (11.6% and 11.2%, respectively; P = 0.43), but ticagrelor was associated with a higher rate of major bleeding not related to coronary-artery bypass grafting (4.5% vs. 3.8%, P = 0.03), including more instances of fatal intracranial bleeding and fewer of fatal bleeding of other types. In patients who have an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke without an increase in the rate of overall major bleeding...
dcterms:title
Ticagrelor versus clopidogrel in patients with acute coronary syndromes Ticagrelor versus clopidogrel in patients with acute coronary syndromes
skos:prefLabel
Ticagrelor versus clopidogrel in patients with acute coronary syndromes Ticagrelor versus clopidogrel in patients with acute coronary syndromes
skos:notation
RIV/00843989:_____/09:00103114!RIV13-MZ0-00843989
n3:aktivita
n8:N
n3:aktivity
N
n3:cisloPeriodika
11
n3:dodaniDat
n14:2013
n3:domaciTvurceVysledku
n9:7051913 n9:5970857
n3:druhVysledku
n11:J
n3:duvernostUdaju
n13:S
n3:entitaPredkladatele
n4:predkladatel
n3:idSjednocenehoVysledku
346324
n3:idVysledku
RIV/00843989:_____/09:00103114
n3:jazykVysledku
n17:eng
n3:klicovaSlova
ST-segment elevation; acute myocardial infarction; P2Y(12) receptor antagonist; prasugrel achieves greater; aspirin treated patients; antiplatelet therapy; platelet aggregation; european society; artery disease; long-term
n3:klicoveSlovo
n10:european%20society n10:antiplatelet%20therapy n10:aspirin%20treated%20patients n10:prasugrel%20achieves%20greater n10:acute%20myocardial%20infarction n10:P2Y%2812%29%20receptor%20antagonist n10:platelet%20aggregation n10:artery%20disease n10:ST-segment%20elevation n10:long-term
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[7177EA321D43]
n3:nazevZdroje
New England Journal of Medicine
n3:obor
n7:FA
n3:pocetDomacichTvurcuVysledku
2
n3:pocetTvurcuVysledku
1134
n3:rokUplatneniVysledku
n14:2009
n3:svazekPeriodika
361
n3:tvurceVysledku
Becker, R. C. Horrow, J. Skene, A. Wallentin, L. Husted, S. Katus, H. Budaj, A. Held, C. Scirica, B. M. Emanuelsson, H. Pleva, Leoš Štípal, Roman Mahaffey, K. W. Cannon, C. P. Harrington, R. A. Steg, P. G. James, S. Storey, R. F.
n3:wos
000269659400007
s:issn
0028-4793
s:numberOfPages
13
n15:doi
10.1056/NEJMoa0904327