In the PLATO trial, ticagrelor compared to clopidogrel in ACS showed:

• A Reduced MI and CV death with similar rates of major bleeding
• B Similar efficacy but significantly reduced intracranial haemorrhage
• C Benefit only in STEMI patients undergoing primary PCI
• D Reduced CV death, MI, and stroke with increased non-CABG-related major bleeding ✓

Explanation

The PLATO trial (NEJM 2009) demonstrated that ticagrelor reduced the primary composite endpoint (CV death, MI, stroke) by 16% relative risk reduction compared to clopidogrel, with a consistent benefit across STEMI and NSTEMI. There was a significant increase in non-CABG-related major bleeding with ticagrelor, though no difference in fatal bleeding. Ticagrelor also reduced CV death specifically (21% RRR). These data established ticagrelor as preferred over clopidogrel for ACS regardless of planned reperfusion strategy.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.