PLATO

Platelet Inhibition and Patient Outcomes

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 18,624 patients hospitalised with ACS, ticagrelor reduced CV death, MI or stroke compared with clopidogrel, with similar major bleeding.

18 624

Schéma

Double-blind RCT, 12 mo

Critère

CV death, MI or stroke at 12 months

Pertinence

Résultat9.8 % vs 11.7 % (HR 0.84). All-cause mortality also reduced.

Wallentin L, et al. N Engl J Med. 2009;361(11):1045-1057. 10.1056/NEJMoa0904327

Discussion et critique

Regional heterogeneity (notably worse outcomes in the US sites) prompted FDA scrutiny — attributed to higher aspirin doses. Dyspnoea and bradycardia are notable adverse signals.