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P2Y₁₂ Inhibitor Monotherapy Better Than Aspirin in Coronary Artery Disease

Medically reviewed by Drugs.com.

By Elana Gotkine HealthDay Reporter

MONDAY, July 10, 2023 -- For patients with coronary artery disease (CAD), P2Y₁₂ inhibitor monotherapy is associated with a lower risk for cardiovascular death, myocardial infarction, and stroke compared with aspirin monotherapy, according to a study published online in the July 11 issue of the Journal of the American College of Cardiology.

Felice Gragnano, M.D., Ph.D., from the University of Campania Luigi Vanvitelli in Naples, Italy, and colleagues conducted a patient-level meta-analysis of data obtained from seven randomized trials comparing P2Y₁₂ inhibitor monotherapy to aspirin monotherapy for the prevention of cardiovascular events in patients with established CAD. The analysis included 24,325 participants: 12,178 were assigned to receive P2Y₁₂ monotherapy (62.0 percent clopidogrel and 38.0 percent ticagrelor), and 12,147 were assigned to receive aspirin.

The researchers found that over two years, the risk for the primary outcome (composite of cardiovascular death, myocardial infarction, and stroke) was lower with P2Y₁₂ inhibitor monotherapy than with aspirin (hazard ratio, 0.88), which was mainly due to less myocardial infarction (hazard ratio, 0.77). The risk for major bleeding was comparable between the groups, and net adverse clinical events were lower with P2Y₁₂ inhibitors (hazard ratio, 0.89). Across prespecified subgroups and types of P2Y₁₂ inhibitors, the treatment effect was consistent.

"Based on available randomized evidence, long-term P2Y₁₂ inhibitor monotherapy may be warranted instead of long-term aspirin monotherapy for secondary prevention in patients with CAD," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2024 HealthDay. All rights reserved.

Posted July 2023

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