The PLATO trial: Do you believe in magic?

The recently published and presented PLATelet Inhibition and Clinical Outcomes (PLATO) trial was a pivotal Phase III, randomized, double-blind, parallel-group, multinational, clinical study.1 The trial compared head-to-head the efficacy of the experimental antiplatelet agent ticagrelor (formerly known as AZD6140, to be marketed as Brilintaw) vs. standard care with clopidogrel. Patients (n = 18 624) with moderate to high risk acute coronary syndromes undergoing coronary intervention were randomized to ticagrelor 180 mg loading dose followed by 90 mg twice daily thereafter, or clopidogrel 300-600 mg loading dose followed by 75 mg once daily for 6-12 months. The primary endpoint was the time of the first event of death from vascular causes, myocardial infarction (MI), or stroke, and occurred in 11.7% of patients treated with clopidogrel vs. 9.8% of patients randomized to ticagrelor, representing a highly significant benefit [hazard ratio (HR)=0.84; confidence interval (CI) =0.77-0.92; P