Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry
Main findingResult — go to the resultAdjusted hazard ratio 0.85 95% CI 0.78–0.93Authors' conclusion
Ticagrelor vs. clopidogrel post-ACS was associated with a lower risk of death, MI, or stroke, as well as death alone. Risk of bleeding was higher with ticagrelor.
Study context
- Population
- Acute coronary syndrome (ACS) patients enrolled in SWEDEHEART, discharged 1 January 2010 to 31 December 2013
- Participants
- 45,073 patients
- Exposure
- Ticagrelor vs clopidogrel
- Ticagrelorn = 11,954
- Clopidogreln = 33,119reference
- Outcome
- Composite of:
- All-cause death
- Re-admission with myocardial infarction (MI)
- Stroke
- Follow-up
- 24 months
Methodological detailsregistry-based (SWEDEHEART)
- Registry-based (SWEDEHEART)
Main finding
As reported in the abstract
Adjusted hazard ratio
0.85
95% CI 0.78–0.93
By group
Ticagrelor vs Clopidogrel
adjusted HR 0.85 (95% CI 0.78–0.93)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Ticagrelor | Clopidogrel | Adjusted HR (CI) | |
|---|---|---|---|---|
| Death · 24 months | 5.8% | 12.9% | 0.83 (0.75–0.92) | |
| MI · 24 months | 6.1% | 10.8% | 0.89 (0.78–1.01) | |
| 0.512Adjusted hazard ratio (log scale) |
Safety
| Outcome | Ticagrelor | Clopidogrel | Estimate | |
|---|---|---|---|---|
| Re-admission with bleeding | 5.5% | 5.2% | adjusted HR 1.20 (CI 1.04–1.40) | |
| PCI-related in-hospital bleeding (PCI subset) | 3.7% | 2.7% | adjusted OR 1.57 (CI 1.30–1.90) | |
| 0.512Ratio (log scale) |
Original publication
Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry. Eur Heart J. Published 19 July 2016. doi:10.
Summarised from the published abstract; every number is checked against it