Ticagrelor Reduces Heart Events

Antiplatelet ticagrelor lowers chance of stroke or heart attack

(RxWiki News) Brilinta (ticagrelor), a blood thinner approved by the U.S. Food and Drug Administration last summer, has been found to not only reduce first time cardiovascular events, but also to lower recurrent heart events or deaths.

Brigham and Women's Hospital researchers found in a meta analysis that the drug appears to reduce recurrent heart attack, stroke, ischemic events, urgent angioplasty to open clogged arteries and heart-related deaths.

"Discuss aspirin dosing in addition to ticagrelor with your cardiologist."

The drug prevents the formation of blood clots to reduce the risk of heart events in patients with acute coronary syndromes, a group of cardiovascular symptoms including heart attack.

Dr. Payal Kohli, lead researcher and a Brigham and Women's Hospital researcher, said the review indicates that if a patient on ticagrelor experiences a cardiac event, continued use of the medication is safe and effective, and may even prevent additional heart events.

Investigators reviewed data from the AstraZeneca-funded PLATO study used to gain FDA approval, which included 18,624 patients with acute coronary syndromes. Those participants were randomly assigned to receive aspirin plus ticagrelor or clopidogrel (Plavix).

No difference in bleeding was found between the two drugs, but questions arose over the study because no benefit was seen in the 1,400 Americans included in the study. More than 300 patients suffered multiple cardiac events during the follow up period.

Ticagrelor had received a favorable review from an FDA advisory committee in mid-2010, but by December 2010, FDA officials declined approval of the drug, instead requesting additional analysis of the PLATO trial. It received the green light from the FDA during the summer of 2011, though approval was granted only with a Risk Evaluation and Mitigation Strategy to ensure the benefits outweighed the risks.

In order to comply with the plan, drugmaker Astra-Zeneca is required to conduct educational outreach with doctors about the risks of using high-dose aspirin with the anti-platelet drug. A medication guide also must be dispensed each time the drug is refilled.

In the latest review of the study, Dr. Kohli also was able to better pinpoint patient populations who appeared more likely to suffer cardiovascular-related events.

"Interestingly, we also found that that those patients who had more cardiac events tended to be older, have a lower body weight and have a higher number of cardiovascular risk factors. There were also a higher proportion of females in this group." Dr. Kohli said.

The study was recently presented at the American College of Cardiology's annual scientific sessions.

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Review Date: 
March 29, 2012