2. Mackay J, et al. The Atlas of Heart Disease and Stroke. Geneva: World Health Organization; 2004:46-47.
Global Average age for ACS presentation
3. 1. Kolanksy DM. Am J Manag Care. 2009;15:S36–S41.
2. Antman EM, et al. Circulation. 2004;110:e82–e292.
3. Braunwald E, et al. Circulation. 2002;106:1893–1900.
4. Boersma E, et al. Circulation 2000;101;2557–2567.
ACS incidence and mortality rates
CV disease deaths due
to ACS
Death in STEMI patients
at 24 hours
Death or MI in NSTE
patients within 30 days
ACS (ST and non-ST elevation)
are responsible for half of all
deaths due to CV disease1
One third of STEMI patients
die within 24 hours of
onset of ischaemia2
15% of NSTE patients die
or have a nonfatal MI
within 30 days3,4
50%
33%
15%
Acute Coronary Syndromes: High Burden of
Mortality
5. Inhibition of Platelet Aggregation 30
Minutes After a Loading Dose of
BRILINTA or Clopidogrel
1. Gurbel PA, et al. Circulation. 2009;120:2577–2585.
2. BRILIQUE EU Label 2010.
*BRILINTA is not indicated for treatment of patients with CAD.
CAUTION: ONSET OF ACTION: Pharmacodynamic data were obtained in patients with stable CAD, not from the PLATO pivotal trial, which studied patients
with ACS. Data on IPA cannot be directly correlated with clinical outcomes. These data cannot be used to extend promotion into stable CAD patients.
Additionally, careful consideration should be given to ensure physical separation of these data from clinical and safety results.
Inhibition of Platelet Aggregation (%)
P<0.0001
100
7. Adapted from Schomig A. N Engl J Med. 2009;361:1108–1111.
Ticagrelor:
Does NOT require metabolic activation to
become active drug
Clopidogrel:
A prodrug; requires metabolism to
become active drug
CYP-dependent
oxidation
CYP1A2
CYP2B6
CYP2C19
CYP-dependent
oxidation
CYP2C19
CYP3A4/5
CYP2B6
Active compound
Intermediate metabolite
Prodrug
Ticagrelor
Clopidogrel
Binding
P2Y12
BRILINTA Does Not Require Hepatic
Metabolism for Activation
Platelet
9. Primary efficacy endpoint: risk reduction to 12 months
Adapted from:
12. Wallentin L, et al. N Engl J Med 2009; 36: 1045-1057.
PLATO: Efficacy & Safety Results
Brilinta 90mg absolute risk reduction starts as early as day 30 and continues to increase
throughout the 12 months12
10. Secondary efficacy endpoint: CV mortality at 12 months12
Adapted from:
12. Wallentin L, et al. N Engl J Med 2009; 36: 1045-1057.
PLATO: Efficacy & Safety Results
Brilinta 90mg demonstrated a 21% RRR in CV mortality vs. clopidogrel
11. PLATO STEMI subgroup13
Adapted from:
13. Steg PG, et al. Circulation 2010; 122: 2131-2141.
PLATO: Efficacy & Safety Results
In the STEMI subgroup of PLATO, Brilinta 90mg demonstrated a 17% RRR in CV
mortality vs. clopidogrel
HR 0.83
(0.67-1.02)
P=0.07
12. ACS Patients Receiving BRILINTA had Fewer Definite
Stent Thrombosis vs. Patients Receiving Clopidogrel 1,2
Adapted from:
.1
Brilinta SmPC 2016. AstraZeneca.
.2
Wallentin L, Becker RC. Budaj A, et al. PLATO Investigators. Ticagrelor versus Clopidogrel in Patients with Acute Cornary Syndrome. N Engl J Med. 2009; 361
(11):1045-1057.
14. Adapted from:
12. Wallentin L, et al. N Engl J Med 2009; 36: 1045-1057.
PLATO: Efficacy & Safety Results
Brilinta 90mg demonstrated no increase in overall major bleeding or fatal bleeding vs.
clopidogrel12
15. Adapted from:
12. Wallentin L, et al. N Engl J Med 2009; 36: 1045-1057.
PLATO: Efficacy & Safety Results
At 12 months, Brilinta showed no significant increase in total major bleeding vs.
clopidogrel12
16. PLATO: Efficacy & Safety Results
No significant difference in major bleeding seen with Brilinta12
Adapted from:
12. Wallentin L, et al. N Engl J Med 2009; 36: 1045-1057.
17. Adapted from:
10. Brilinta SmPC 2016. AstraZeneca
12. Wallentin L, et al. N Engl J Med 2009; 361: 1045-1057.
Conclusion
Brilinta is simple and effective in the management of your ACS patients for up to 12
months*10,12
✝Unless contraindicated
