Ticagrelor
The PLATO (Platelet Inhibition and Patient Outcomes)
RCT found that ticagrelor significantly
reduced major cardiovascular events from 11.7%
to 9.8% (HR 0.84, 95% CI 0.77–0.92) compared
with clopidogrel, including a significant absolute
decrease of 1.1% in vascular mortality.25 Rates of
major bleeding related to non cardiac surgery
were increased from 3.8% to 4.5% (HR 1.19,
95% CI 1.02–1.38). Because heterogeneity of
ticagrelor effect by geographical region was
linked to the ASA dose used concomitantly, it is
indicated only in association with low-dose
(≤ 100 mg daily) ASA.26