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Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack

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Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack. / Johnston, S Claiborne; Amarenco, Pierre; Albers, Gregory W; Denison, Hans; Easton, J Donald; Evans, Scott R; Held, Peter; Jonasson, Jenny; Minematsu, Kazuo; Molina, Carlos A; Wang, Yongjun; Wong, K S Lawrence; SOCRATES Steering Committee and Investigators.

in: NEW ENGL J MED, Jahrgang 375, Nr. 1, 07.07.2016, S. 35-43.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Johnston, SC, Amarenco, P, Albers, GW, Denison, H, Easton, JD, Evans, SR, Held, P, Jonasson, J, Minematsu, K, Molina, CA, Wang, Y, Wong, KSL & SOCRATES Steering Committee and Investigators 2016, 'Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack', NEW ENGL J MED, Jg. 375, Nr. 1, S. 35-43. https://doi.org/10.1056/NEJMoa1603060

APA

Johnston, S. C., Amarenco, P., Albers, G. W., Denison, H., Easton, J. D., Evans, S. R., Held, P., Jonasson, J., Minematsu, K., Molina, C. A., Wang, Y., Wong, K. S. L., & SOCRATES Steering Committee and Investigators (2016). Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack. NEW ENGL J MED, 375(1), 35-43. https://doi.org/10.1056/NEJMoa1603060

Vancouver

Johnston SC, Amarenco P, Albers GW, Denison H, Easton JD, Evans SR et al. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack. NEW ENGL J MED. 2016 Jul 7;375(1):35-43. https://doi.org/10.1056/NEJMoa1603060

Bibtex

@article{c3166b6a0e3443bc89ad642548310484,
title = "Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack",
abstract = "BACKGROUND: Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia.METHODS: We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90). The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days.RESULTS: During the 90 days of treatment, a primary end-point event occurred in 442 of the 6589 patients (6.7%) treated with ticagrelor, versus 497 of the 6610 patients (7.5%) treated with aspirin (hazard ratio, 0.89; 95% confidence interval [CI], 0.78 to 1.01; P=0.07). Ischemic stroke occurred in 385 patients (5.8%) treated with ticagrelor and in 441 patients (6.7%) treated with aspirin (hazard ratio, 0.87; 95% CI, 0.76 to 1.00). Major bleeding occurred in 0.5% of patients treated with ticagrelor and in 0.6% of patients treated with aspirin, intracranial hemorrhage in 0.2% and 0.3%, respectively, and fatal bleeding in 0.1% and 0.1%.CONCLUSIONS: In our trial involving patients with acute ischemic stroke or transient ischemic attack, ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death at 90 days. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01994720.).",
keywords = "Adenosine, Aged, Aspirin, Double-Blind Method, Female, Hemorrhage, Humans, Ischemic Attack, Transient, Kaplan-Meier Estimate, Male, Middle Aged, Platelet Aggregation Inhibitors, Purinergic P2Y Receptor Antagonists, Stroke, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't",
author = "Johnston, {S Claiborne} and Pierre Amarenco and Albers, {Gregory W} and Hans Denison and Easton, {J Donald} and Evans, {Scott R} and Peter Held and Jenny Jonasson and Kazuo Minematsu and Molina, {Carlos A} and Yongjun Wang and Wong, {K S Lawrence} and {SOCRATES Steering Committee and Investigators} and G{\"o}tz Thomalla",
year = "2016",
month = jul,
day = "7",
doi = "10.1056/NEJMoa1603060",
language = "English",
volume = "375",
pages = "35--43",
journal = "NEW ENGL J MED",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "1",

}

RIS

TY - JOUR

T1 - Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack

AU - Johnston, S Claiborne

AU - Amarenco, Pierre

AU - Albers, Gregory W

AU - Denison, Hans

AU - Easton, J Donald

AU - Evans, Scott R

AU - Held, Peter

AU - Jonasson, Jenny

AU - Minematsu, Kazuo

AU - Molina, Carlos A

AU - Wang, Yongjun

AU - Wong, K S Lawrence

AU - SOCRATES Steering Committee and Investigators

AU - Thomalla, Götz

PY - 2016/7/7

Y1 - 2016/7/7

N2 - BACKGROUND: Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia.METHODS: We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90). The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days.RESULTS: During the 90 days of treatment, a primary end-point event occurred in 442 of the 6589 patients (6.7%) treated with ticagrelor, versus 497 of the 6610 patients (7.5%) treated with aspirin (hazard ratio, 0.89; 95% confidence interval [CI], 0.78 to 1.01; P=0.07). Ischemic stroke occurred in 385 patients (5.8%) treated with ticagrelor and in 441 patients (6.7%) treated with aspirin (hazard ratio, 0.87; 95% CI, 0.76 to 1.00). Major bleeding occurred in 0.5% of patients treated with ticagrelor and in 0.6% of patients treated with aspirin, intracranial hemorrhage in 0.2% and 0.3%, respectively, and fatal bleeding in 0.1% and 0.1%.CONCLUSIONS: In our trial involving patients with acute ischemic stroke or transient ischemic attack, ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death at 90 days. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01994720.).

AB - BACKGROUND: Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia.METHODS: We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90). The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days.RESULTS: During the 90 days of treatment, a primary end-point event occurred in 442 of the 6589 patients (6.7%) treated with ticagrelor, versus 497 of the 6610 patients (7.5%) treated with aspirin (hazard ratio, 0.89; 95% confidence interval [CI], 0.78 to 1.01; P=0.07). Ischemic stroke occurred in 385 patients (5.8%) treated with ticagrelor and in 441 patients (6.7%) treated with aspirin (hazard ratio, 0.87; 95% CI, 0.76 to 1.00). Major bleeding occurred in 0.5% of patients treated with ticagrelor and in 0.6% of patients treated with aspirin, intracranial hemorrhage in 0.2% and 0.3%, respectively, and fatal bleeding in 0.1% and 0.1%.CONCLUSIONS: In our trial involving patients with acute ischemic stroke or transient ischemic attack, ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death at 90 days. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01994720.).

KW - Adenosine

KW - Aged

KW - Aspirin

KW - Double-Blind Method

KW - Female

KW - Hemorrhage

KW - Humans

KW - Ischemic Attack, Transient

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Platelet Aggregation Inhibitors

KW - Purinergic P2Y Receptor Antagonists

KW - Stroke

KW - Comparative Study

KW - Journal Article

KW - Multicenter Study

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1056/NEJMoa1603060

DO - 10.1056/NEJMoa1603060

M3 - SCORING: Journal article

C2 - 27160892

VL - 375

SP - 35

EP - 43

JO - NEW ENGL J MED

JF - NEW ENGL J MED

SN - 0028-4793

IS - 1

ER -