Ticagrelor vs. Clopidogrel in PLATO Patients with Prior Stroke or Transient Ischemic Attack

In the PLATelet inhibition and patient Outcomes (PLATO) trial, ticagrelor — an oral, nonthienopyridine P2Y₁₂ inhibitor — was superior to clopidogrel for the prevention of cardiovascular death, myocardial infarction (MI), or stroke in patients with acute coronary syndromes (JW Cardiol Sep 2 2009). Ticagrelor did not increase the risk for major bleeding, even though it provides faster and more complete platelet inhibition than clopidogrel. The PLATO investigators have now analyzed the findings in the subgroup of patients with a history of stroke or transient ischemic attack (TIA).

This subgroup, comprising 1152 (6%) of the 18,624 patients in the main study, was older than the overall group and had higher event rates. The result of the ticagrel…