MANILA, Philippines; 11 November 2014 — The American Heart Association (AHA) and American College of Cardiology (ACC) in its latest guideline cited ticagrelor, an antiplatelet medication1 (P2Y12 inhibitor), as a preferred drug for patients with certain acute coronary syndromes.
According to the guideline, ticagrelor is now preferred over clopidogrel for the management of “non-ST-elevation ACS (NSTE-ACS)” in patients who undergo an early invasive (angiography with intent for PCI if appropriate) or ischemia-guided strategy (i.e., medically managed), or those who receive a coronary stent.2
The guideline supports differentiation among the currently available antiplatelet agents (P2Y12 inhibitors), including ticagrelor, clopidogrel, and prasugrel, for such patients. This is the first time the AHA and ACC have recommended one P2Y12 over another in the treatment of acute coronary syndrome (ACS).2
ACS is an umbrella term for conditions that result from insufficient blood supply to the heart muscle, ranging from unstable angina (unremitting chest pain that threatens a heart attack) to heart attack.4
Different treatment strategies have been developed for heart attack patients. However, the risk of death due to a heart attack remains high: nearly 1 in 6 patients may die within the first year of their heart attack.5
“We at AstraZeneca are very pleased with the latest development with the AHA/ACC guideline recognizing ticagrelor as the preferred drug over the current standard of care in the treatment of NSTE-ACS patientsundergoing a broad range of treatment strategies,” said Gagan Singh, President, AstraZeneca Philippines.
“The inclusion and citation of ticagrelor as a preferred drug in the 2014 AHA/ACC guideline, reveals a renewed confidence in both the medicine and the PLATO data that support these new recommendations,” added Dr. Milagros Tan-Pineda, Medical and Regulatory Affairs Director, AstraZeneca Philippines.
This new guideline is based on a review of multiple clinical trials, including PLATO. PLATO was a large (18,624 patients in 43 countries), head-to-head patient outcomes study of ticagrelor vs. clopidogrel, both given in combination with aspirin and other standard therapy.
The trial was designed to establish whether ticagrelor plus aspirin could achieve a clinically meaningful reduction in cardiovascular (CV) events in acute coronary syndrome (ACS) patients, above and beyond that afforded by clopidogrel plus aspirin. Patients were treated for at least 6 months and up to 12 months.
Ticagrelor plus aspirin has been proven clinically superior to clopidogrel plus aspirin, in reducing thrombotic CV events, including CV death, at 12 months, based on the data from the PLATO trial3.
Ticagrelor is indicated to reduce the rate of thrombotic cardiovascular (CV) events in patients with ACS (unstable angina [UA], non–ST-elevation myocardial infarction [NSTEMI], or ST-elevation myocardial infarction [STEMI]). It has been shown to reduce the rate of a combined end point of CV death, myocardial infarction (MI), or stroke compared to clopidogrel.
The difference between treatments was driven by CV death and MI with no difference in stroke. In patients treated with percutaneous coronary intervention (PCI), it also reduces the rate of stent thrombosis.2
Ticagrelor belongs to a new class of oral antiplatelet treatment for ACS that works by preventing the formation of new blood clots and maintaining blood flow in the body to help reduce a patient’s risk of suffering another (potentially fatal) heart attack.4
In total, ticagrelor is included in 12 major US and Global ACS management guidelines and recognized in several of them as an important part of the standard of care in a broad range of invasively or noninvasively managed patients with ACS.2
- 1 http://content.onlinejacc.org/article.aspx?articleid=1144137: JACC Volume 7, Issue, Feb2011
- 2 3049019-AHA ACC NSTE-ACS Guideline Update Press Release-FINAL-CC-10.3.14…
- 3 Wallentin L, et al. N Engl J Med. 2009;361:1045–1057
- Accessed 25 July 2012
- 5Tang EW, et al. Am Heart J, 2007; 153:29035