Abstract
Cardiovascular disease (CVD) still rank first among mortality causes worldwide. Occurrence of atherothrombotic events can be influence with consistent intervention of all risk factors of atherosclerosis and also antiplatelet therapy that is particularly important in the secondary prevention of CVDs.
In addition to acetylsalicylic acid, antiplatelet therapy most commonly relies on drugs from the group of platelet receptor P2Y12 blockers (irreversible blockers are clopidogrel and prasugrel, reversible blockers are ticagrelor and cangrelor). PLATO (acetylsalicylic acid + ticagrelor vs. acetylsalicylic acid + clopidogrel within 24 hours of acute coronary syndrome) was a large clinical trial that showed higher efficacy of ticagrelor with comparable risk of bleeding complications, shifting ticagrelor to one of the leading positions in the setting of dual therapy.
Another large clinical trial, PEGASUS-TIMI 54 (patients 1-3 years after myocardial infarction, randomization ratio 1 : 1 : 1 to ticagrelor 2x 90 mg vs. 2x 60 mg vs. placebo to continued therapy with acetylsalicylic acid), showed continued protective effect of dual therapy (ASA + ticagrelor) for more than 12 months.