Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes – PLATO Trial

In a study comparing ticagrelor with clopidogrel in patients with acute coronary syndrome, ticagrelor was found to significantly reduce the rate of death from vascular causes, myocardial infarction, or stroke, with a similar benefit seen for the individual components of death from vascular causes and myocardial infarction, but not stroke. Ticagrelor did not significantly increase the rate of major bleeding. These benefits were seen in patients with and without ST-segment elevation and regardless of the treatment received with clopidogrel, as well as in both the short and long term. Ticagrelor was also found to be associated with a reduction in the rate of death from any cause and in the risk of coronary thrombotic events, without an increase in the risk of major bleeding. Dyspnea occurred more frequently with ticagrelor, but most episodes were short-lived and only 0.9% of patients in the ticagrelor group discontinued the drug due to this side effect. Ticagrelor may be a useful alternative to clopidogrel in the treatment of acute coronary syndrome.