Ticagrelor has been promoted to reduce the rate of definite stent thrombosis compared to clopidogrel from the The Platelet Inhibition and Patient Outcomes (PLATO) trial. However, several issues prevent this statement from being accurate, (1) stent thrombosis was an exploratory endpoint in PLATO--cases were retrospectively and prospectively adjudicated, (2) Sampling/ascertainment bias most likely lead to these conclusions, (3) Stent thromboses were not confirmed by an angiographic core lab (a requirement by the ARC definition for 'definite stent thrombosis'), (4) The integrity of the mortality and MI data from the PLATO trial have recently been challenged. A statement that ticagrelor reduces definite stent thrombosis versus clopidogrel cannot be justified.

译文

从血小板抑制和患者结果 (PLATO) 试验中,与氯吡格雷相比,替格瑞洛已被推广以降低确定的支架内血栓形成率。然而,有几个问题阻碍了这一说法的准确性,(1) 支架血栓形成是PLATO的探索性终点-病例是回顾性和前瞻性裁决的,(2) 抽样/确定偏差最有可能导致这些结论,(3) 血管造影核心实验室未确认支架血栓形成 (ARC定义对 “确定的支架血栓形成” 的要求),(4) PLATO试验的死亡率和MI数据的完整性最近受到挑战。与氯吡格雷相比,替格瑞洛减少明确的支架内血栓形成的说法是不合理的。

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