In the PLATO trial, ticagrelor compared to clopidogrel in ACS patients showed which PRIMARY outcome benefit?
- A Reduction in cardiovascular death, MI and stroke with increased non-CABG major bleeding ✓
- B Reduction in all-cause mortality, MI and stroke without increase in major bleeding
- C Reduction in stent thrombosis only, with no mortality benefit
- D Superiority only in STEMI subgroup, not NSTEMI
Correct answer: A. Reduction in cardiovascular death, MI and stroke with increased non-CABG major bleeding
Explanation
The PLATO trial demonstrated that ticagrelor significantly reduced the composite of cardiovascular death, MI, and stroke by 16% (relative risk reduction) compared to clopidogrel in ACS. There was also a significant reduction in cardiovascular and all-cause mortality. However, non-CABG-related major bleeding was increased with ticagrelor. The benefit was consistent across STEMI and NSTEMI subgroups.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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