Ticagrelor vs. Clopidogrel in Peripheral Artery Disease

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No better for primary efficacy composite end point of cardiovascular death, myocardial infarction, stroke
No better for primary efficacy composite end point of cardiovascular death, myocardial infarction, stroke

HealthDay News — Ticagrelor is not superior to clopidogrel for reduction of cardiovascular events in patients with peripheral artery disease, according to a study published online November 13 in the New England Journal of Medicine to coincide with the annual meeting of the American Heart Association, held from November 12 to 16 in New Orleans.

William R. Hiatt, MD, from the University of Colorado School of Medicine in Aurora, and colleagues compared clopidogrel with ticagrelor in patients with peripheral artery disease. A total of 13,885 patients with symptomatic peripheral artery disease with an ankle brachial index of 0.80 or less or who had undergone previous revascularization of the lower limbs were randomized to monotherapy with ticagrelor or clopidogrel.

The researchers found that the primary efficacy end point (composite of adjudicated cardiovascular death, myocardial infarction, or ischemic stroke) occurred in 10.8 and 10.6% of patients receiving ticagrelor and clopidogrel, respectively (hazard ratio, 1.02; 95% confidence interval, 0.92 to 1.13). Acute limb ischemia occurred in 1.7% of patients in each group (hazard ratio, 1.03; 95% confidence interval, 0.79 to 1.33) and major bleeding occurred in 1.6% of each group (hazard ratio, 1.10; 95% confidence interval, 0.84 to 1.43).

"In patients with symptomatic peripheral artery disease, ticagrelor was not shown to be superior to clopidogrel for the reduction of cardiovascular events," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Astra Zeneca, which manufactures ticagrelor and funded the study.

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