The American Heart Association ( AHA ) and the American College of Cardiology ( ACC ) in their latest guideline cited Ticagrelor ( Brilinta, Brilique ), a P2Y12 inhibitor with antiplatelet activity, as a preferred drug for patients with certain acute coronary syndromes ( ACS ).

According to the guideline, Ticagrelor is now preferred over Clopidogrel ( Plavix ) for the management of non-ST-elevation ACS ( NSTE-ACS ) in patients who undergo an early invasive ( angiography with intent for percutaneous coronary intervention if appropriate ) or ischemia-guided strategy ( i.e., medically managed ), or those who receive a coronary stent.

This new guideline is based on a review of multiple clinical trials, including PLATO. PLATO was a large ( 18,624 patients in 43 countries ) head-to-head patient outcomes study of Ticagrelor versus Clopidogrel, both given in combination with Acetylsalicylic acid ( Aspirin ) and other standard therapy, designed to establish whether Ticagrelor plus Acetylsalicylic acid could achieve a clinically meaningful reduction in cardiovascular events in ACS patients.
Ticagrelor plus Acetylsalicylic acid has been proven clinically superior to Clopidogrel plus Acetylsalicylic acid in reducing thrombotic cardiovascular events, including cardiovascular death, at 12 months,

Ticagrelor is indicated to reduce the rate of thrombotic cardiovascular events in patients with ACS ( unstable angina [ UA ], non–ST-elevation myocardial infarction [ NSTEMI ], or ST-elevation myocardial infarction [ STEMI ] ).
It has been shown to reduce the rate of a combined end point of cardiovascular death, myocardial infarction or stroke compared to Clopidogrel. The difference between treatments was driven by cardiovascular death and myocardial infarction with no difference in stroke.
In patients treated with percutaneous coronary intervention ( PCI ), it also reduces the rate of stent thrombosis. ( Xagena )

Source: AstraZeneca, 2014