Which Antiplatelet Therapy for Older Adults with Acute Coronary Syndrome?

Clopidogrel was noninferior to ticagrelor and was associated with lower bleeding in an open-label, randomized, controlled trial.

Guidelines recommend more-potent P2Y12 inhibitors (ticagrelor and prasugrel) over clopidogrel following a non–ST-segment elevation acute coronary syndrome (NSTE-ACS). However, in older adults, the risks for bleeding might outweigh the thrombotic benefits of more-potent antiplatelet therapy. Researchers in the POPular AGE trial (NCT02317198) randomized 1002 patients aged ≥70 presenting with NSTE-ACS at 12 hospitals in the Netherlands between 2013 and 2018 to receive clopidogrel or a more-potent P2Y12 inhibitor (ticagrelor or prasugrel, chosen by the treating physician). Treatment was open-label and began with a standard loading dose within 72 hours of presentation, followed by a maintenance dose for 1 year. The primary outcomes were major or…

Reviewing Author

Fatima Rodriguez, MD, MPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardNovoNordisk; HealthPals; Novartis; Amgen

EquityHealthPals; Carta

Grant/Research SupportNational Institutes of Health/National Heart, Lung, and Blood Institute; American Heart Association–Robert Wood Johnson Foundation

Editorial BoardsCardiology and Therapy

Fatima Rodriguez, MD, MPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardNovoNordisk; HealthPals; Novartis; Amgen

EquityHealthPals; Carta

Grant/Research SupportNational Institutes of Health/National Heart, Lung, and Blood Institute; American Heart Association–Robert Wood Johnson Foundation

Editorial BoardsCardiology and Therapy

Which Antiplatelet Therapy for Older Adults with Acute Coronary Syndrome?

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Reviewing Author