AHA/ACC recommends ticagrelor over clopidogrel for NSTE-ACS

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AstraZeneca has announced that the American Heart Association/American College of Cardiology, in their updated the guideline for the management of patients with non–ST-elevation acute coronary syndromes (NSTE-ACS), has given Class IIa recommendation for use of ticagrelor (Brilinta) over clopidogrel in patients with NSTE-ACS undergoing early invasive or ischaemia-guided strategy or receiving a stent. A company press release reports that the guideline supports differentiation among currently available P2Y12 inhibitors, including ticagrelor, clopidogrel, and prasugrel, for these patients.

The press release reports that the updated guideline means that in, the USA, Brilinta is now preferred over clopidogrel for the management of NSTE-ACS patients who undergo an early invasive (angiography with intent for percutaneous coronary intervention if appropriate) or ischaemia-guided strategy (ie. medically managed), or those who receive a coronary stent. It adds that this is the first time the AHA and ACC have recommended one P2Y12 over another in the treatment of acute coronary syndrome.


“AstraZeneca is pleased that the AHA/ACC guideline recognises the role of ticagrelor over clopidogrel in the treatment of NSTE-ACS patients undergoing a broad range of treatment strategies,” says Gregory F Keenan, vice president and US head medical officer, AstraZeneca. “This guideline update demonstrates how the standards of ACS care continue to evolve and include Brilinta, reinforcing the confidence the guideline committee has in both the medicine and the PLATO data that supports these new recommendations.”


This new guideline is based on a review of multiple clinical trials, including PLATO. There are no clinical outcome trials that compare prasugrel and ticagrelor. In total, BRILINTA is included in 12 major US and Global ACS management guidelines and recognized in several of them as an important part of the standard of care in a broad range of invasively or noninvasively managed patients with ACS.