Print Share Email Send Email Your Name (required) ! Example: John Doe Email Address (required) ! Error: Please enter a valid sender email address. Example: email@example.com CC Me Recipient Email Address (required) ! Separate multiple email address with semi-colons (up to 5). Subject Subject for your email. Message (Maximum characters: 1,000) Error: Please enter your name Error: Please enter your email address Error: Please enter a valid recipient email address. Example:firstname.lastname@example.org Thank you! Your email has been sent to: The recipient(s) will receive an email message that includes a link to the selected article. Recipients may need to check their spam filters or confirm that the address is safe. Return to: Send Another Email An error has occurred sending your email(s). Please try again later or contact an administrator at OnlineCustomer_Service@email.mheducation.com. Return to: Twitter Facebook Linkedin Reddit Get Citation Citation AMA Citation Goodman J, Goldman ME. Goodman J, Goldman M.E. Goodman, Jason, and Martin E. Goldman. "POPular AGE: Clopidogrel Reduces Bleeding Compared with Ticagrelor or Prasugrel in Patients Aged ≥70 Years with Non-ST-Segment Elevation Coronary Syndrome." Hurst's the Heart Updates, 16 October 2019. McGraw-Hill, New York, NY, 2019. AccessCardiology. http://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506587§ionid=229608450 MLA Citation Goodman J, Goldman ME. Goodman J, Goldman M.E. Goodman, Jason, and Martin E. Goldman.. "POPular AGE: Clopidogrel Reduces Bleeding Compared with Ticagrelor or Prasugrel in Patients Aged ≥70 Years with Non-ST-Segment Elevation Coronary Syndrome." Hurst's the Heart Updates Fuster V. Fuster V Fuster, Valentin. New York, NY: McGraw-Hill, 2019, http://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506587§ionid=229608450. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Tools Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Top POPular AGE: Clopidogrel Reduces Bleeding Compared with Ticagrelor or Prasugrel in Patients Aged ≥70 Years with Non-ST-Segment Elevation Coronary Syndrome by Jason Goodman, Martin E. Goldman Listen + +Update to Chapter 41: Antiplatelet and Anticoagulant Therapy in Acute Coronary Syndrome Study Summary + +The POPular AGE trial was a prospective, randomized, open-label study with a blinded clinical event committee, designed to address optimal dual antiplatelet therapy (DAPT) in elderly individuals, who have an inherent increased risk of bleeding. Patients aged ≥70 years admitted for NSTE-ACS were randomly assigned to aspirin and either clopidogrel (n = 501) or ticagrelor or prasugrel (n = 502) for 12 months. The primary safety endpoint of bleeding (as defined in the PLATO trial) was found in 17.6% of the clopidogrel group compared with 23.1% of the prasugrel/ticagrelor arm (P = 0.03). The primary efficacy endpoint — a composite of death, MI, stroke, and bleeding — occurred in 27.3% of the clopidogrel group compared with 30.7% of the ticagrelor/prasugrel group (P for noninferiority = 0.06). Commentary + +Study Strengths: This study addressed an important clinical question, which will become ever more relevant as life expectancy increases and treatment populations age. The committee responsible for determining clinical events was blinded to the treatment arm. +Study Limitations: This study was not double-blinded. As the population of this study was of Dutch origin, the generalizability of the results to other populations is unclear, and this study should be repeated with a more diverse patient population. Adherence to the study drug was only 51% in the ticagrelor/prasugrel group, but 76% in the clopidogrel group, which might have affected the primary efficacy outcome. Many of the patients received DAPT prior to randomization, which may further cloud the results. +Next Steps/Clinical Perspectives: In patients aged ≥70 years with NSTE-ACS, clopidogrel was associated with less bleeding without a significant increase in major adverse cardiac events when compared with more-potent P2Y12 inhibitors. As elderly patients are underrepresented in many clinical trials, this study provides guidance for the use of antiplatelet agents in this population. Trial Reference + + + +Presented by Marieke E. Gimbel at the European Society of Cardiology Congress, Paris, France, August 31 2019.