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Ticagrelor, an oral, non-thienopyridine, P2Y12-receptor blocker, is reversible (within 2–3 days of drug cessation) and is more potent and rapid-acting than clopidogrel. Oral ticagrelor outperformed clopidogrel in the recent manufacturer-funded PLATO trial involving more than 18,500 patients with acute coronary syndromes (ACS) with or without ST-segment elevation (JW Cardiol Sep 2 2009). Now, in a prespecified PLATO substudy, investigators have analyzed data on the 13,408 patients who were slated before randomization to undergo early invasive treatment. Patients were assigned to receive ticagrelor (180–270 mg loading dose followed by 90 mg twice daily) or clopidogrel (300–600 mg loading dose followed by 75 mg daily) for 6 to 12 months.
At 1 y…