{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:05:16Z","timestamp":1791266716562,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,11,23]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Aspirin and clopidogrel are recommended for patients with acute coronary syndromes (ACS) or undergoing coronary stenting. Ticagrelor, a reversible oral P2Y12-receptor antagonist, provides faster, greater, and more consistent platelet inhibition than clopidogrel and may be useful for patients with acute ST-segment elevation (STE) ACS and planned primary percutaneous coronary intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Result\u2014<\/jats:title>\n            <jats:p>\n              Platelet Inhibition and Patient Outcomes (PLATO), a randomized, double-blind trial, compared ticagrelor with clopidogrel for the prevention of vascular events in 18 624 ACS patients. This report concerns the 7544 ACS patients with STE or left bundle-branch block allocated to either ticagrelor 180-mg loading dose followed by 90 mg twice daily or clopidogrel 300-mg loading dose (with provision for 300 mg clopidogrel at percutaneous coronary intervention) followed by 75 mg daily for 6 to 12 months. The reduction of the primary end point (myocardial infarction, stroke, or cardiovascular death) with ticagrelor versus clopidogrel (10.8% versus 9.4%; hazard ratio [HR], 0.87; 95% confidence interval, 0.75 to 1.01;\n              <jats:italic>P<\/jats:italic>\n              =0.07) was consistent with the overall PLATO results. There was no interaction between presentation with STE\/left bundle-branch block and randomized treatment (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.29). Ticagrelor reduced several secondary end points, including myocardial infarction alone (HR, 0.80;\n              <jats:italic>P<\/jats:italic>\n              =0.03), total mortality (HR, 0.82;\n              <jats:italic>P<\/jats:italic>\n              =0.05), and definite stent thrombosis (HR, 0.66;\n              <jats:italic>P<\/jats:italic>\n              =0.03). The risk of stroke, low in both groups, was higher with ticagrelor (1.7% versus 1.0%; HR,1.63; 95% confidence interval, 1.07 to 2.48;\n              <jats:italic>P<\/jats:italic>\n              =0.02). Ticagrelor did not affect major bleeding (HR, 0.98;\n              <jats:italic>P<\/jats:italic>\n              =0.76).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion\u2014<\/jats:title>\n            <jats:p>In patients with STE-ACS and planned primary percutaneous coronary intervention, the effects of ticagrelor were consistent with those observed in the overall PLATO trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.ClinicalTrials.gov\">http:\/\/www.ClinicalTrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00391872.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.109.927582","type":"journal-article","created":{"date-parts":[[2010,11,9]],"date-time":"2010-11-09T07:14:14Z","timestamp":1289286854000},"page":"2131-2141","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":450,"title":["Ticagrelor Versus Clopidogrel in Patients With ST-Elevation Acute Coronary Syndromes Intended for Reperfusion With Primary Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"122","author":[{"given":"Philippe Gabriel","family":"Steg","sequence":"first","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"James","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Harrington","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ardissino","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C.","family":"Becker","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Emanuelsson","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen","family":"Husted","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Katus","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kilhamn","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Olofsson","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Storey","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Douglas","family":"Weaver","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wallentin","sequence":"additional","affiliation":[{"name":"From INSERM U-698, Paris, France (P.G.S.); H\u00f4pital Bichat-Claude Bernard, AP-HP, Paris, France (P.G.S.); Universit\u00e9 Paris 7, Paris, France (P.G.S.); Uppsala Clinical Research Center and Department Medical Sciences, Uppsala University, Uppsala, Sweden (S.J., S.O., L.W.); Duke Clinical Research Institute, Durham, NC (R.A.H., R.C.B.); Azienda Ospedaliero Universitaria di Parma, Parma, Italy (D.A.); TIMI Study Group, Brigham and Women's Hospital, Boston, Mass (C.P.C.); AstraZeneca Research and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the PLATO Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn416"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.188209"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.03.083"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61845-0"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0809171"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1232"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808227"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.056"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000130846.46168.03"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05701-4"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000140675.85342.1b"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.07.053"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi754"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.07.058"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.912550"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.01.003"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.188208"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.187397"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.3081"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.17.2031"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60441-4"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0665"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.07.026"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-5922.2009.00096.x"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309023291001"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.109.927582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:37:41Z","timestamp":1715578661000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.109.927582"}},"subtitle":["A Platelet Inhibition and Patient Outcomes (PLATO) Trial Subgroup Analysis"],"short-title":[],"issued":{"date-parts":[[2010,11,23]]},"references-count":27,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2010,11,23]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.109.927582"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.109.927582","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,23]]},"assertion":[{"value":"2009-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-09-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-11-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}