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N Engl J Med. 2015 May 7;372(19):1791-800. doi: 10.1056/NEJMoa1500857. Epub 2015 Mar 14.

Long-term use of ticagrelor in patients with prior myocardial infarction.

Collaborators (2350)

Abola MT, Ardissino D, Aylward P, Budaj A, Corbalan R, Dalby A, Dellborg M, Diaz R, Dimulescu D, Goto S, Goudev A, Guneri S, Hamm C, Hu D, Isaza D, Kamensky G, Kiss R, Kontny F, Lopez-Sendon J, Medina F, Montalescot G, Nicolau J, Oude Ophuis T, Paolasso E, Parkhomenko A, Ruda M, Seung KB, Spinar J, Theroux P, Van de Werf F, Diaz R, Paolasso E, Alvarisqueta A, De Gennaro N, Berli M, Roude AE, Albisu Di Gennaro J, Albisu JF, Caccavo A, Torres M, Cuadrado J, Bordoni P, Cuello J, Aviles A, Glenny A, Recoaro R, Fernández R, Strada BN, Fuentealba V, Gallo C, García Duran R, Garcia C, Hominal M, Castoldi M, Jure H, Ferre Pacora F, Lorenzatti A, Martínez JM, Macín S, Cocco N, MacKinnon I, Bagnato MB, Marino J, Cusimano S, Arias V, Focaccia M, Muntaner J, Mansilla V, Poy C, Prado A, Paterlini G, Montaña O, Camino A, Sala J, Luciani C, Vico M, Morell Y, Dumont C, Vottero E, Zangroniz P, Viso ME, Lescano A, Morara P, Lobo Marquez L, Risso Patrón F, Bustamante Labarta G, Sivila CD, Quiroga AR, Maffei L, Sassone S, Rolandi F, Vesentini N, Carnero G, Del Verme S, Hershson A, Figal JC, Aylward P, Hii C, Smith K, Singh B, Acampo M, Rogers J, Odonoghue M, Amerena J, Long A, Dart A, Kay S, Worthley M, Nimmo J, Lehman R, Morrison H, Dick R, Savage C, van Gaal W, Park M, Blombery P, McCarthy C, Oqueli E, Hill D, Sader M, Vrachas D, Purnell P, Vibert J, Collins N, Gordon A, Arstall M, Rose J, Aroney C, Cleave P, Fitzpatrick M, Mackenzie M, Garrahy P, Hall C, Nelson G, Reid E, Lee A, Gibbs J, Thompson P, Crittenden J, Hammett C, Hindom L, Antonis P, Manzoney A, Cross D, Pollard C, Brieger D, Wu J, Whelan A, Tulloch G, Taylor A, Smith B, Horowitz J, Black M, Van de Werf F, Boland J, Malmendier D, Celen H, Wendelen E, Claeys M, Pieter M, Cools F, Simons N, De Maeseneire S, De Maeseneire S, De Wolf L, Brike C, Dubois P, Condé Y Bolado A, Foading-Deffo B, Tahon S, Friart A, Arend C, Gevaert S, Verdegem P, Marechal P, Gits F, Pierard L, Celentano C, Pirenne B, Bouvy C, Renkin J, Huyberechts D, Sinnaeve P, De Velder L, Stammen F, Casier T, Striekwold H, Van den Broeck D, Thoeng J, Goris R, Timmermans P, Collard SJ, van de Borne P, De Clippel M, Wollaert B, Jacobs C, Vankelecom B, Daelemans Y, Vervoort G, Drieghe S, Vranckx P, Janssen A, Vrolix M, Simenon I, Wijns W, Delacroix H, Wollaert B, Denie D, Schoors D, Lemoine I, Cornelis K, Willems AM, Schröder E, Domange J, Nicolau JC, Greque G, Machado H, Armaganijan D, Del Monaco MI, da Silva D, Nakasone R, Dutra O, Vaz R, Daher R, Rodrigues D, Guimarães A, Teixeira A, Saraiva J, Costa M, Leães P, Blacher M, Maia L, Nakazone MA, Manenti E, Ruschel K, Marin-Neto J, Pavao R, Alves Junior Á, Oliveira G, Rassi S, Sampaio D, Rossi PR, dos Santos L, de Souza J, Lino E, Pimentel Filho P, Zucchetti C, Gomes M, de Paiva A, Sousa AC, Almeida A, Botelho R, da Silva R, Giraldez R, Franken M, Faludi A, Bertolami M, Hernandes M, Lucas N, Carvalho A, Bertolami A, Precoma D, Geralde L, Pereira A, Pereira A, Cesar L, Mioto B, Marino R, Rabelo W, dos Santos F, Vidotti MH, Mangione J, Mauro M, Kormann A, Ultramari F, Zimmermann S, Zimmermann E, Michalaros Y, Fonseca M, Sampaio C, Eliaschewitz F, Barbosa E, Drews C, de Lorenzo A, Barros C, Neuesnchwander F, Cançado G, Goudev A, Benov H, Vasileva D, Chompalova B, Parishev G, Denchev S, Milcheva N, Gocheva N, Avramov D, Mihov A, Miteva B, Mincheva V, Stoyanovski V, Pencheva G, Pencheva G, Gelev V, Nikolova L, Tisheva S, Stancheva N, Todorov G, Nyagina M, Goudev A, Markov D, Parvanova Z, Spirova D, Peneva Y, Peneva Y, Todorova M, Peshkov O, Mitkova M, Mitkova L, Smilov L, Mandzhukova S, Yakovova S, Rangelova V, Milanova K, Ivanov K, Aleksov N, Krusheva B, Mollov M, Raycheva V, Gergova V, Gergova V, Shishmanova D, Goranov K, Stoykov A, Stoykov A, Hristova K, Staleva M, Uzunangelov Y, Rashkova V, Postadzhian A, Postadzhian A, Peltegov V, Krancheva V, Karamitev G, Lulova E, Theroux P, Bertrand O, Jadin M, Cantor W, Robbins K, Constance C, Gauthier MF, Gosselin G, Masson C, Tishler S, Reyes V, Marr D, O'Blenis G, Pandey AS, Clarus S, Pesant Y, Sardin V, Pouliot J, Marquette S, Gladstone P, Bozek B, McPherson T, Spurrell D, Rupka D, Thiessen S, Saw J, Fox R, St-Amour E, Tremblay I, Syan G, Singh J, Syan R, Samms S, Rosenbloom A, Ross B, Vizel S, Solomon P, Della Siega A, Nelson S, Halperin F, Roberts P, Nigro F, Forsyth C, Chehayeb R, Lepage C, Fell D, McPherson C, Labonte R, Dewar C, Nawaz S, Dewar C, Gupta M, dela Cruz C, Ma P, Louch D, Glanz A, Vilag C, Kouz S, Roy M, Bhargava R, Stata C, Dion D, Morissette A, Dupuis R, Ouimet F, Grondin F, Bilodeau N, Wong B, Dewar C, Sabbah E, Chausse I, Hui W, Kvill L, Belisle P, Chartrand MJ, Tymchak W, Harris L, Montigny M, Bolduc H, Lonn E, Magi A, Bose S, Jule P, Kincade D, Valley S, Gallo R, Morrissette J, Lamy A, Power P, Bell A, Kailey P, LeMay M, Thomas A, Bata I, Wright D, Kostuk W, Carr S, Cheung S, Cleveland T, Petrella R, Dihel C, Lubelsky B, Coldwell J, Berlingieri J, Schellenberg S, Fortin C, Viau C, DeYoung JP, Watt M, Babapulle M, Corke R, Landry D, Shea-Landry G, Gupta A, Gandhi A, Corbalan R, Prieto JC, Noriega V, Cobos L, Obreque C, Potthoff S, Zapata J, Lucero F, Luque M, Pincetti C, Torres G, Yañez M, Vasquez C, Manriquez L, Espinoza MJ, Yovaniniz P, Grandon M, Castro P, Llevaneras S, Lanas F, Hidalgo J, Arriagada G, Villan C, Florenzano F, Chacon MV, Rodriguez M, Barreda B, Raffo C, Reyes T, Hu D, Hu D, Liu W, Tan N, Feng Y, Dong Y, Yang D, Liao Y, Wei F, Wei M, Yan M, Yan X, Wang S, Chen Y, Li Y, Yuan Z, Xiong Y, Zhu J, Li S, Ma G, Chen L, Li Z, Liu Y, Yang X, Xiong W, Pang W, Chen Y, Lu G, Chen Z, Zhao S, Zhou H, Huang J, Gang Y, Chai Y, Yang X, Zhang Z, Mu Z, Isaza D, Hernandez E, Mora C, Maria E, Catalan Y, Reynales H, Huertas D, Molina D, Rendon N, Sanchez G, Tellez R, Botero R, Salazar P, Vesga B, Delgado P, Herrera M, Perez D, Jaramillo N, Toloza R, Orozco A, Bustamante Y, Jaramillo C, Garces G, Saaibi J, Castillo J, Arana C, Gonzalez M, Urina M, Ramirez N, Manzur F, Rosales D, Quintero A, Gonzalez E, Accini J, Reyes M, Spinar J, Elbl L, Malecha J, Stanek L, Jerabek O, Kos P, Zidkova E, Lubanda H, Naplava R, Vlckova D, Ludkova A, Ludka O, Kuchar J, Wasserburger B, Sperlingova B, Linhart A, Rihacek I, Soucek M, Spinar J, Poloczek M, Spinarova L, Panovsky R, Bren J, Cermak O, Macha J, Svobodova I, Grunfeldova H, Monhart Z, Zanova M, Pleva L, Zarembova J, Polasek R, Sembera Z, Dedek V, Janota T, Stipal R, Sipula J, Kucera D, Kolmas P, Bednarova J, Lukac M, Reichert P, Turkova N, Petrova I, Broulova P, Matyasek I, Hanak P, Brychta T, Bouchal P, Machova V, Krocova E, Marusincova I, Montalescot G, Steg PG, Oudghiri M, Montalescot G, Bertin B, Macquin-Mavier, Beitar T, Khalife K, Merkling D, Galley D, Beltra C, Elhadad S, Maubert A, Decoulx E, El Jarroudi M, Cottin Y, Bichat F, Coisne D, Berger N, Bonnet JL, Fiacchetti C, Ferrari E, Douillet M, Range G, Laure C, Cayla G, Leperchois-Jacquey C, Goralski M, Miran S, Furber A, Cornet C, Elbaz M, Rosolin N, Aboyans V, Pradel V, Poulard JE, Leparree S, Zemour G, Doux N, Labeque JN, Mais C, Hirsch JL, Sevilla J, Vaquette B, Laurencon V, Livarek B, Georges JL, Igigabel P, Gilard V, Lafitte S, Duprat C, Hamm C, Hamm C, Kisselbach C, Giannitsis E, Deigentasch H, Schenkenberger I, Dreykluft K, Appel KF, Becker P, Toursarkissian N, Scheuren A, Bott J, Erdas M, Nischik R, Wipper J, Schmidt E, Schmidt A, Jung T, Henzler A, Steiner S, Winter K, Fischer S, Fischer S, Khariouzov A, Kopf S, Heuer H, Laschewski B, Kadel C, Rahn G, Hanefeld M, Schrapel C, Weil J, Miodek M, Koenig W, Hildenbrand S, Horacek T, Fink P, Muenzel T, Gebel G, Brachmann J, Goebel U, Weber D, Siepmann C, Wittlich N, Drexler A, Stellbrink C, Iselt M, Düngen HD, Maiwald A, Leschke M, Blaich B, Zeymer U, Baumann S, Dorsel T, Iselt M, Voehringer HF, Gebhardt S, Dissmann M, Kazcmarek N, vom Dahl J, Krug-Hoeren B, Borst M, Träubler B, Derwahl KM, Nicula D, Trenk D, Reichenbach D, Frey N, Langer C, Schroeder T, Kiroglu K, Foerster A, Riedel S, Bartels R, Schulte M, Kiss R, Katona A, Erdei F, Vértes A, Sebõ J, Kiss R, Korda A, Túri T, Túri T, Merkely B, Becker D, Ungi I, Kalapos A, Király C, Boskó M, Zólyomi S, Pap G, Horváth I, Magyari B, Lupkovics G, Basa A, Édes I, Jenei C, Simon É, Bakai J, Czuriga I, Unterberger K, László Z, Vas K, Kancz S, Fülöp G, Takács J, Nagy MA, Papp A, Takács Á, Czigány A, Máté Z, Müller G, Szilágyi A, Sipos Tas A, Nagy K, Polgár P, Sváb M, Józan Jilling M, Kis E, Bartal G, Horthy R, Kerkovits A, Kántor F, Bódi M, Sperr E, Benczúr B, Bajcsi É, Valcó J, Bujdosó Á, Ardissino D, Ardissino D, Notarangelo F, Martina P, Stefanin C, Fiscella A, Giacoppo M, Marenzi G, Rubino M, Tamburino C, Dammino L, Terrosu P, Chessa P, Presbitero P, Di Pizzo A, Cuccia C, Musmeci G, Bovenzi F, Mazzoni A, Berti S, Tyack K, Colivicchi F, Aiello A, Paloscia L, Mascellanti M, Scherillo M, Formigli D, Tartaglione S, Guglielmino G, Della Rovere F, Bernabò P, De Cesare N, Bocciarelli M, Manari A, De Iaco G, Astarita C, Russo G, Oltrona L, Rizzotti D, Marzilli M, Orsini E, Caldarola P, Sublimi Saponetti L, Merlini P, Babbolin M, Celentano A, De Divitiis M, Di Sciascio G, Patti G, Pajes G, Monti F, Silvestri O, Silvestri N, Delfino R, Valbusa A, Bassani F, Lazzarotti M, Puccetti L, Puccetti L, Cavallini C, Grikstaite E, Patrizi G, Patrizi G, Fattore L, Bosco B, Di Lorenzo L, Marchegiano R, Goto S, Takenaka T, Teranishi J, Ono M, Sakuma K, Suzuki M, Abe Y, Hasegawa K, Suzuki A, Domae H, Yamazaki A, Fukui K, Nakachi T, Iseki H, Nagayama H, Aoyama T, Fujino S, Suzuki C, Tsurukai A, Sakai R, Nojima S, Hashimoto T, Inoko M, Ishiguchi Y, Sasaki T, Hada K, Kataoka T, Nakatani K, Okutsu M, Yamamoto K, Yasaka Y, Matsuo A, Miyamoto T, Yamaguchi E, Tomobuchi Y, Ito S, Tamura R, Matsuda M, Hosokawa S, Onishi M, Komura Y, Kawanishi Y, Takahashi N, Ohashi Y, Mima T, Ochi K, Sadamatsu K, Miyamoto S, Fujimoto K, Ichishita Y, Matsumura T, Iwamoto H, Koide S, Sagara Y, Himi T, Komori M, Hashimoto Y, Matsumura A, Yamasaki M, Nakashima R, Okubo M, Kondo M, Takase H, Suzuki K, Morii I, Utsu N, Kodama S, Higashino Y, Kotajima H, Shigematsu S, Fujimoto N, Nakagawa T, Honda K, Goto S, Iwamoto M, Ota T, Okada S, Takahashi W, Ichinose K, Kakishita M, Hayashi Y, Takinami N, Momiyama Y, Takagi E, Baden M, Suzuki K, Saeki T, Nakano A, Hiroi S, Tomari H, Aoyama T, Yokoyama T, Wada A, Matsui Y, Nakata A, Nishimura N, Nishi Y, Asano T, Hirasawa S, Mochiduki A, Shibata Y, Yamashita S, Fukuzawa S, Okino S, Machida M, Hirabayashi K, Takama N, Funada R, Oude Ophuis T, Wardeh AJ, Dille C, de Melker EC, van der Spoel A, Willems FF, Maassen E, Westendorp IC, Zweers D, Dunselman PH, Blom L, Ronner E, Wissenburg A, van der Sluis A, Badings EA, den Hartog FR, Singerling M, Aksoy I, Heil A, Tjeerdsma G, van Daalen C, Lenderink T, Lardenois R, Prins FJ, Rutten R, Plomp J, Veldmeijer S, de Vries RJ, Krikken J, Oude Ophuis TA, Buvelot S, Bos RJ, Tan-Urgert B, Werner HA, Wittekoek M, van Daele ME, Bouwens M, Oomen A, Meijlis P, Verheul JA, Uiterwaal H, Knufman N, de Lange H, Bartels GL, Hendriks-van Woerden M, van Bemmel B, Beyering M, Zwart PA, Teng Y, van der Zwaan C, Havenaar J, Hermans WR, de Graauw J, Hamraoui K, Dabrowska K, de Nooijer C, Groenenberg I, Kietselaer BL, Muis L, Hamer BJ, Hobe C, van Eck JW, Elzebroek N, Tans JG, Stapel AG, Nierop PR, Dirks M, Kuijper AF, Schiks M, de Groot MR, Post G, ten Berg JM, Bras R, Koolen JJ, van Leur L, Herrman JP, Roelse A, Ebink C, Jones B, Lipsic E, Couperus M, Bogaard K, Dijk A, Kontny F, Pettersen KI, Kontny F, Fortun M, Gullestad L, Stueflotten W, Popovic I, Turkerud Søbye E, Høgalmen G, German M, Hysing J, Flagstad E, Slettom G, Nordrehaug JE, Isaksen A, Graven T, Haug H, Sandvik J, Thunhaug H, Bjørnerud Rønning P, Gravrok B, Lappegård KT, Enebakk T, Rønnevik P, Rønnevik T, Hurtig U, Skanke E, Omland T, Tobiassen GM, Medina F, Berrospi P, Ragas Y, Bustamante G, Marruffo Y, Chavez E, Chaname A, Heredia J, Gamero K, Lema J, Carrión AM, Rodríguez V, Cabanillas N, Rodriguez A, Zeña N, Segura L, Rojas C, Toce L, Carrera J, Orihuela B, Del Portal M, Roldan Y, Roldán G, Medina F, Rodriguez J, Chávez C, Luna G, Parra J, Ramos J, Mogrovejo W, Godoy J, Zubiate Talledo M, Diestra J, Godoy A, Matta M, Pino C, Vergara R, Chois A, Guillen AM, Medina J, Chirinos J, Paredes A, Quiroz M, Camacho L, Gil M, Abola MT, Abola MT, Cerbito S, Beltran J, Tanglao M, Uy N, Busa J, Rogelio G, Arbis MG, Prado JP, Miranda M, Sulit DJ, Dioquino R, Sevilla R, Soriano RA, Rosita RR, Amazona A, Atilano A, Lim E, Ebo G, Maglasang P, Palmes P, Loreno CA, Tirador L, Alagban C, Roxas DJ, Roxas JF, Cheng F, De Guzman S, Morales D, Mararac T, Barbas B, Barbas K, Ferrolino A, Baysac C, Llarena AC, Julianes C, Budaj A, Budaj A, Torun A, Dalkowski M, Widejko K, Derlaga B, Laskowska Derlaga E, Dudek D, Dziewierz A, Jozwa R, Busz-Papiez B, Pawlowicz L, Kaczmarczyk M, Jaworska K, Skonieczny G, Kopaczewski J, Wujkowski M, Krasowski W, Krzyzanek P, Kubica J, Kozinski M, Miekus P, Glaza M, Podolec P, Wilkolek P, Piepiorka M, Piepiorka-Broniecka M, Pluta W, Ploch M, Rynkiewicz A, Mosakowska K, Szpajer M, Lesinski D, Szwed H, Jasek S, Sciborski R, Piotrowicz R, Musial W, Lisowska A, Rekosz J, Kasznicka M, Korzeniak R, Staneta P, Konczakowski P, Waluszek-Konczakowska I, Cymerman K, Cymerman K, Lubinski A, Grycewicz T, Hiczkiewicz J, Plucinski M, Korol M, Korol M, Szczech J, Hawro M, Skorski M, Cichoń K, Jankowski M, Jankowski M, Cygler J, Ottomanska-Cygler M, Korecki J, Gulaj E, Zechowicz T, Zechowicz M, Goch A, Topolinski B, Ogorek M, Szczepanska A, Wojewoda P, Jagoda E, Krzyzanowski W, Muzyk-Osikowicz M, Jaszczurowski W, Jaszczurowski W, Stasiewski A, Wietrzynska J, Miklaszewicz B, Beme A, Sudnik W, Matys U, Ponikowski P, Powierza S, Seung KB, Kim YH, Chang KC, Choi DJ, Yoon CH, Seung KB, Chang K, Lim DS, Park JH, Lee SH, Choi SH, Kim HS, Park KW, Bae JH, Bae YH, Hong TJ, Lee HW, Hong MK, Kim BK, Tahk SJ, Yoon MH, Kim YJ, Park JS, Yoon J, Jang H, Jeong MH, Kim C, Chae JK, Cho EJ, Cho MC, Bae JH, Hong SK, Lee HJ, Hur SH, Lee DJ, Jeong JO, Lee JW, Her SH, Park MW, Lee JM, Choi YY, Dimulescu D, Dimulescu D, Huidu S, Vintila MM, Protopopescu L, Fruntelata A, Greavu MC, Pirvu O, Diaconu MC, Stanciulescu G, Blajan D, Giuca A, Istratoaie O, Militaru C, Lican G, Radoi M, Bisoc A, Bobescu E, Doka B, Crisu D, Jemna D, Creteanu M, Parasteac MM, Minescu B, Serban LD, Bolohan F, Mihai M, Manitiu I, Cioca G, Bengus CM, Ochean V, Iosipescu LC, Costache L, Ciobotaru V, Andor M, Basarab G, Stoica D, Benedek IS, Benedek T, Constantinescu M, Sava N, Cristea MI, Anciu MR, Capalneanu R, Mot S, Tatu-Chitoiu GP, Cornaciu S, Ruda M, Boldueva S, Samokhvalova M, Golitsyn S, Mironova N, Karpov Y, Buza V, Kobalava Z, Shavarov A, Konstantinov V, Serebrenitskaya M, Kuimov A, Khomyakova L, Ezhov M, Safarova M, Panov A, Lohovinina N, Ruda M, Staroverov I, Novikova T, Bitakova F, Simanenkov V, Zakharova N, Smolenskaya O, Khurs E, Tsyba L, Belenky D, Vishnevsky A, Kositsyn D, Yakhontova P, Rovnykh Y, Kislyak O, Kasatova T, Demchenko E, Lubinskaya E, Yakovlev A, Omelchenko M, Ermoshkina L, Slukhaenko I, Arkhipov M, Kozulin A, Galyavich A, Baleeva L, Strongin L, Pochinka I, Kosmacheva E, Kizhvatova N, Goloshchekin B, Laptev I, Sidorenko B, Bugrimova M, Izmozherova N, Popov A, Shustov S, Kovalevskaya E, Orlikova O, Orlikov E, Paltsman Z, Paltsman Z, Lukyanov Y, Lamden D, Koziolova N, Surovtseva M, Nedogoda S, Tsoma V, Statsenko M, Derevjanchenko M, Kotelnikov M, Streltsov S, Osipenko M, Bikbulatova E, Oshchepkova E, Dmitriev V, Bolieva L, Byazrova S, Ryamzina I, Khovaeva Y, Pavlysh E, Komandenko O, Kamensky G, Kamensky G, Dlesk A, Urban M, Urban M, Vinanska D, Vinanska D, Dzupina A, Dzupina A, Hranai M, Cisar P, Toth P, Toth P, Paulov S, Paulov S, Sivak V, Sivak V, Bolvanska N, Bolvanska N, Pella D, Pella D, Palka J, Palka J, Nedelova I, Nedelova I, Benacka J, Benacka J, Gergel V, Gergel V, Hatalova K, Cisar P, Kohut P, Kohut P, Kovar F, Knazeje M, Macek V, Macek V, Sinska R, Sinska R, Bugan V, Bugan V, Dalby A, Badenhorst JC, Erasmus L, Burgess LJ, de Necker I, Corbett CH, Fouche L, Dawood SY, Conradie C, Delport EF, Kruger M, Ebrahim I, Bobak C, Nethononda MR, Nunkoo T, Janse van Rensburg FP, Middle R, Horak AR, Henley L, Mabin TA, King A, Ranjith N, Ramdas S, Roodt A, Coetsee E, Theron H, Karsten M, Van Zyl LJ, Roscher M, Venter TP, de Kock L, Becker AC, Swanepoel J, Ismail SM, Christie H, Dalby AJ, Allman J, Roux JP, Christie H, Naidoo DP, Vawda GH, Manga P, Olckers W, Mpe MT, Farrell BM, Lopez-Sendon J, Lopez de Sa Areses E, Valbuena López S, Cruz Fernández JM, Gonzalez Roldan J, Garcia Pavia P, Gonzalez Segovia A, Garcia Puig J, Velasco Garcia C, Muñoz Aguilera R, Dominguez Muñoa M, Bruguera Cortada J, Cabero Cereto P, Plaza Pérez I, Perez Cid L, Galve Basilio E, Cibeira Guerra P, Fernández Ortiz A, Vivas Balcones LD, Ripoll Vera T, Gamez Martinez JM, De Teresa Galvan E, Hernandez Caballero A, Rodríguez Blanco VM, Rubín 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C.

Abstract

BACKGROUND:

The potential benefit of dual antiplatelet therapy beyond 1 year after a myocardial infarction has not been established. We investigated the efficacy and safety of ticagrelor, a P2Y12 receptor antagonist with established efficacy after an acute coronary syndrome, in this context.

METHODS:

We randomly assigned, in a double-blind 1:1:1 fashion, 21,162 patients who had had a myocardial infarction 1 to 3 years earlier to ticagrelor at a dose of 90 mg twice daily, ticagrelor at a dose of 60 mg twice daily, or placebo. All the patients were to receive low-dose aspirin and were followed for a median of 33 months. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The primary safety end point was Thrombolysis in Myocardial Infarction (TIMI) major bleeding.

RESULTS:

The two ticagrelor doses each reduced, as compared with placebo, the rate of the primary efficacy end point, with Kaplan-Meier rates at 3 years of 7.85% in the group that received 90 mg of ticagrelor twice daily, 7.77% in the group that received 60 mg of ticagrelor twice daily, and 9.04% in the placebo group (hazard ratio for 90 mg of ticagrelor vs. placebo, 0.85; 95% confidence interval [CI], 0.75 to 0.96; P=0.008; hazard ratio for 60 mg of ticagrelor vs. placebo, 0.84; 95% CI, 0.74 to 0.95; P=0.004). Rates of TIMI major bleeding were higher with ticagrelor (2.60% with 90 mg and 2.30% with 60 mg) than with placebo (1.06%) (P<0.001 for each dose vs. placebo); the rates of intracranial hemorrhage or fatal bleeding in the three groups were 0.63%, 0.71%, and 0.60%, respectively.

CONCLUSIONS:

In patients with a myocardial infarction more than 1 year previously, treatment with ticagrelor significantly reduced the risk of cardiovascular death, myocardial infarction, or stroke and increased the risk of major bleeding. (Funded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.).

PMID:
25773268
[PubMed - indexed for MEDLINE]
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