Efficacy and Safety Profile of Ticagrelor in ACS Found to Be Independent of Age as Compared With Clopidogrel
NEW ORLEANS, LA—Ticagrelor demonstrated comparable efficacy and safety to clopidogrel in elderly patients (>75 years) with acute coronary syndrome (ACS) who are at higher risk for recurrent ischemic events, death, and treatment-related complications, according to study data presented at ACC.11, the American College of Cardiology's 60th Annual Scientific Session.
Investigators Steen Husted, MD, from the Arhus University Hospital, Arhus, Denmark, and colleagues performed a subanalysis of the PLATO (PLATelet inhibition and patient Outcomes) trial investigating the association between age and cardiovascular death, myocardial infarction (MI), stroke, definite stent thrombosis, major bleeding and non-CABG major bleeding using Cox proportional hazards. See Table. Similar models were used to evaluate the interaction of age with treatment effects.
Irrespective of treatment, rates of adjusted hazard ratios (adjusted for differences in baseline characteristics) were higher in patients aged ≥75 years compared with those <75 years for cardiovascular death, MI, and stroke (HR=1.48 [1.32–1.66]), total mortality (HR=1.95 [1.66–2.27]) and overall major bleeding (HR=1.11 [0.97–1.26]).
Compared with clopidogrel, the reduction of ischemic endpoints and mortality in ACS patients with ticagrelor therapy without an increase in major bleeding was independent of patient age. Adverse effects of dyspnea and ventricular pauses observed more often during ticagrelor treatment also did not differ among age groups.
The study authors reported that the results suggest that the significant clinical benefit and overall safety of ticagrelor vs. clopidogrel in ACS patients are independent of age. These findings are consistent with the overall PLATO trial results and other secondary analyses.