POPular AGE Trial Summary: Antiplatelet agent in NSTEMI

popular age trial

2020 POPULAR AGE TRIAL Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome multicenter, randomized controlled trial Objective: To evaluate the effectiveness of clopidogrel compared with ticagrelor or prasugrel among patients ≥70 years of age being treated for a non-ST-segment elevation acute coronary syndrome (NSTE-ACS) 1002 patients Inclusion criteria: Patients ≥70 years with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) < 72 hours Ө VS Clopidogrel group (n=500) Ticagrelor or prasugrel group (n=502) 18 28 PRIMARY OUTCOMES PLATelet inhibition and patient Outcomes (PLATO) major & minor bleeding% HR 0.71; 95% CI, 0.54 to 0.94; P=0.02 for superiority Net clinical benefit outcome of all-cause death, MI, Stroke, PLATO major & minor bleeding % Diff -4; 95% CI, -10.0 to 1.4; P=0.03 for non-inferiority SECONDARY OUTCOMES 24 32 8 PLATO major bleeding % P=0.11 12 0 Fatal bleeding % P=0.03 1.0 Conclusion: Clopidogrel is a favourable alternative to ticagrelor, because it leads to fewer bleeding events without an increase in the combined endpoint of all-cause death, myocardial infarction, stroke, and bleeding M Gimbel et al. Lancet 2020;395:1374-1381