ATLANTIC Trial: Prehospital Ticagrelor for STEMI
Ticagrelor (Brilinta) is a reversible, direct acting P2Y12 receptor antagonist which prevents ADP-mediated activation of GPIIb/IIIa receptor complexes thereby reducing platelet aggregation. It is indicated for the management of patients with acute coronary syndrome.
- The ATLANTIC trial was an international, multicentered, randomized, double-blind clinical trial of 1,862 patients with ongoing STEMI of < 6 hrs duration.
- Giving ticagrelor pre-hospital vs. in the cath lab showed no advantage in resolution of ST-segment elevation, major adverse CV events or rates of bleeding, but did show a small benefit in definite stent thrombosis.
Take Home Point:
- Compared to In-hospital administration, the prehospital administration of ticagrelor appears to be safe and may offer a small benefit in preventing stent thrombosis after more definitive treatment with PTCA and without any difference in major bleeding.
ATLANTIC Trial: Summary