Blood thinners are often given to individuals who recently received percutaneous coronary intervention (PCI), more commonly known as heart stenting, in order to prevent dangerous blood clots and strokes. Although the newer drug Brilinta tends to be the blood thinner of choice, a new study suggests it performs no better than Plavix at preventing adverse events.
Researchers from New York and South Korea sought to determine whether Brilinta earned its reputation as the go-to blood thinner for heart stent patients. However, findings published this week in the Journal of the American Medical Association (JAMA) suggests there is no evidence it should put it above Plavix, and the medication was not associated with better outcomes.
Brilinta (ticagrelor) is a blood thinner used to reduce the risk of cardiovascular death, heart attacks and strokes in patients with acute coronary syndrome (ACS), or by those with history of heart attacks. Brilinta is also commonly used to reduce the rate of stent thrombosis in patients who have received stents for treatment of ACS.
A PCI is a type of heart stent used to widen the arteries when a person is suffering from narrowed arteries from coronary artery disease, or heart disease.
The researchers conducted a retrospective cohort study of patients with ACS who had received a heart stent and were prescribed either Brilinta or Plavix (clopidogrel), using data from two U.S. electronic health databases and one national database from South Korea. Researchers looked at data from November 2011 to March 2019.
The study was designed to look for adverse events after a year, including heart attacks, revascularization, ischemic stroke or bleeding. They also looked for mortality rates and dyspnea.
According to the findings, the one year risk of net adverse clinical events (NACE) was not significantly different between the two drugs, with a 15.1% NACE rate among those using Brilinta, and a 14.6% rate among those using Plavix. There was also no significant difference in all-cause mortality or strokes.
However, the risk of hemorrhagic events and dyspnea were found to be significantly higher among patients taking Brilinta.
“Among patients with ACS who underwent PCI in routine clinical practice, ticagrelor, compared with clopidogrel, was not associated with significant difference in the risk of NACE at 12 months,” the researchers concluded. “Because the possibility of unmeasured confounders cannot be excluded, further research is needed to determine whether ticagrelor is more effective than clopidogrel in this settling.”
Other studies have indicated taking Brillinta with aspirin increased the risk of serious bleeding. Another study published in 2016 indicated patients taking Brillinta before heart surgery faced an increased risk of up to 20% for bleeding events.