Replication of the PLATO Antiplatelet Trial in Healthcare Claims Data

Inclusion Criteria

• •Please see: https://drive.google.com/drive/folders/1WD618wrywYjEaXzfLTcuK-VCcnb6b-gV for full code and algorithm definitions.
• •Market availability of ticagrelor in the U.S. started on 2011-07-20.
• •For Marketscan: 2011-07-20 to 2017-12-31 (end of data availability).
• •For Optum: 2011-07-20 to 2019-03-31 (end of data availability).
• •1-4 ALL REQUIRED
• •* 1\. Hospitalized for potential ST-segment elevation or non-ST-segment elevation ACS, with onset during the previous 24 hours, documented by cardiac ischemic symptoms due to atherosclerosis of ≥10 minutes' duration at rest
• •* 2\. ≥18 years of age
• •* 3\. Not pregnant. Urinary and/or blood pregnancy tests are to be performed in women of child-bearing potential and repeated at least every 6 months. Women of child-bearing potential must be using ≥2 forms of reliable contraception, including one barrier method.
• •* 4\. With informed consent 1-4 AND 5A OR 5B
• •5A. ≥2 of the following:
• •* 1\. ST-segment changes on ECG indicating ischemia. ST-segment depression or transient elevation ≥ 1 mm in two or more 2 contiguous leads"
• •* 2\. Positive biomarker indicating myocardial necrosis. Troponin I or T or CK-MB greater than the upper limit of normal
• •* 3\. One of the following:
• •1. ≥60 y of age
• •2. Previous MI or CABG
• •3. CAD with ≥50% stenosis in ≥2 vessels
• •4. Previous ischemic stroke, TIA (hospital-based diagnosis), carotid stenosis (≥50%), or cerebral revascularization
• •5. Diabetes mellitus
• •6. Peripheral artery disease
• •7. Chronic renal dysfunction
• •OR
• •5B. Persistent ST-segment elevation ≥1 mm (not known to be preexisting or due to a coexisting disorder) in ≥2 contiguous leads or new LBBB plus primary PCI planned.