Longer term treatment reduces risk of repeat heart attacks

Study shows longer term treatment reduces risk of repeat heart attacks

A new international study of 21,000 people who had suffered heart attacks has shown that their risk of repeat heart attacks is significantly reduced if they are treated with a medicine called BRILINTA® (ticagrelor) in addition to aspirin and continued for up to three years, compared to the current standard of care, which is treatment with aspirin alone.

BRILINTA is a heart medication that helps stop the clumping of platelets. This reduces the chance of a blood clot forming that can reduce blood flow.

More than 15,000 New Zealanders currently suffer a heart attack each year. Recent research has shown that one in five heart attack patients will have a further heart attack, stroke or cardiovascular (CV) event in the three years following a heart attack.

A new major study, PEGASUS-TIMI 54 (PEGASUS), presented at the American College of Cardiology 64th Annual Scientific Session, and published in the New England Journal of Medicine, has shown that people who had experienced a heart attack at least one year prior to study enrolment had a reduced combined risk of cardiovascular death, repeat heart attack or stroke after being treated with BRILINTA tablets plus low dose aspirin for a longer period, compared to those treated with aspirin alone.

In this trial, at 3 years both doses of BRILINTA were shown to significantly reduce the combination of CV death, heart attack or stroke compared to treatment with aspirin alone. In addition, the reduction in CV events with both doses of BRILINTA appeared consistent across major subgroups including, but not limited to, age, sex and type of heart attack.

Dr Gerard Devlin, cardiologist at Waikato Hospital, said the study had identified a group of patients at high risk who stood to benefit from a new approach to extended treatment.
Virginia Sutherland, General Manager of AstraZeneca in New Zealand, said: “As a company we are committed to cardiovascular research and are proud to have delivered the PEGASUS study which is both one of AstraZeneca’s largest clinical trial and the first prospective trial to evaluate longer term dual antiplatelet therapy in higher risk patients with a history of a heart attack.

Major bleeding is a recognised side effect of this class of medicine. Major bleeding was higher with BRILINTA than with aspirin alone, but importantly rates of fatal bleeding were low and were similar between the patients treated with BRILINTA and those treated with aspirin alone.

Long term treatment presented challenges in managing side effects, Dr Devlin said, making it important to assess patients who were best suited for the treatment. “But the good thing in this study is that while there was an increased risk of bleeding in people treated with BRILINTA this did not result in death or intracranial haemorrhage [bleeding within the skull]”.

He also welcomed the study’s finding that the 60mg dose of BRILINTA with aspirin had similar efficacy to the 90mg dose. “That means patients may require less medication to reap its benefits, and may experience fewer side effects as a result of the lower dose.”

“The key thing for people to remember who have had a heart attack is that they need to look after themselves. Don’t smoke. People also often don’t understand the reasons for the medications they are on and why these are often life-long. I would urge patients to discuss these things with their health care professional and not to stop taking any medication without talking to them. These are lifesaving medications. “

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