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Question clinique
Is ticagrelor (Brilinta) better than aspirin as antiplatelet treatment in adults after coronary artery bypass grafting?
L’Essentiel
This study found that ticagrelor is not superior to (and may actually be inferior to) aspirin in preventing major adverse cardiovascular events in adults after coronary artery bypass grafting (CABG). The study was halted prematurely because of slow recruitment, low event rates, and early withdrawal of commercial funding. The current GoodRx price for 1 month of ticagrelor is $405.00. Looks like it's best to stick with aspirin whenever possible. 1b
Référence
Plan de l'etude: Randomized controlled trial (double-blinded)
Financement: Industry
Cadre: Inpatient (any location) with outpatient follow-up
Sommaire
Previous studies have reported a tendency toward higher graft patency rates in post-CABG adults with ticagrelor plus aspirin compared with aspirin alone. These investigators identified consenting adults (N = 1893), 18 years or older, with an acute coronary syndrome or stable coronary artery disease who met standard criteria for CABG surgery. Within the first 24 hours after surgery, eligible patients randomly received (concealed allocation assignment) either aspirin 100 mg once daily or ticagrelor 90 mg twice daily using a double-dummy design to mask study medication. Individuals who assessed outcomes remained masked to treatment group assignment. Complete follow-up occurred for all patients for 12 months. Using intention-to-treat analysis, the primary composite outcome of cardiovascular death, myocardial infarction, stroke and repeat revascularization occurred nonsignificantly more (since the trial was prematurely stopped) in the ticagrelor group than in the aspirin group (9.7% vs 8.2%, respectively). None of the individual components of the primary end point showed a significant difference, including the secondary outcomes of all-cause death and major bleeding events.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Commentaires
Subject: ASPIRIN is much better than TICAGRELOR(BRILINTA)
Dear respected Team-CMA-Canada,
Thank you dear respected Sir/Mam for all of your cooperation to me as Global Family Doctor at SIG Based in Manikganj-Bangladesh.
I have studied the medical education tropic/subject on ASPIRIN and TICAGRELOR ( BRILINTA). ASPIRIN helps the patients /adults /old persons to prevent much strokes/brain stroke/heart stroke/heart infection etc.
But, TICAGRELOR ( BRILINTA) does not work like ASPIRIN as per the researchers /doctors long days observation information and survey results .
Due to heart problems patients/clients,. They should keep ASPIRIN always with them as per the prescribed medicine and counseling by experienced doctors /heart specialists .
Best wishes to all.
Respectfully.
Dr.Muhammad Arif Rana
Global Family Doctor (LDM-224)-WONCA at SIG Based in Manikganj-Bangladesh.
Health Professional Member-52698-MDS-USA.
International Resident Member-ID -44770918-(Resident-424504)-SRPC-CANADA.
International Resident Member-(IMG)-CMAID-680777-CMA-Canada.
(SIG).
Working Place at Postgraduate Librarian Professional for the last more than 16 years (From October-2002 To 2019-still serving ) in Manikganj-Bangladesh.
Muhammad Arif Rana
Assistant Librarian (AL-843687)
Rajibpur Adarsha College
Manikganj-Bangladesh.
Email:muhammadarifrana3@gmail.com
Date: October 23-2019-Wednesday- 10:10 AM.
(With heartiest wishes and Respectfully)