Association of ticagrelor-aspirin versus clopidogrel-aspirin with efficacy and safety outcomes stratified by age
| Outcomes | Age | Ticagrelor-aspirin group n/N (%) | Clopidogrel-aspirin group n/N (%) | HR/OR (95% CI)* | Log-rank p value | P interaction |
| Efficacy outcomes | ||||||
| Stroke | <65 | 82/1602 (5.1) | 125/1649 (7.6) | 0.68 (0.51 to 0.91) | 0.008 | 0.23 |
| 65–80 | 87/1396 (6.2) | 101/1359 (7.4) | 0.81 (0.60 to 1.09) | 0.17 | ||
| ≥80 | 22/207 (10.6) | 17/199 (8.5) | 1.00 (0.49 to 2.06) | 0.99 | ||
| Stroke within 30 days | <65 | 68/1602 (4.2) | 104/1649 (6.3) | 0.67 (0.49 to 0.92) | 0.01 | 0.33 |
| 65–80 | 69/1396 (4.9) | 87/1359 (6.4) | 0.75 (0.54 to 1.04) | 0.09 | ||
| ≥80 | 19/207 (9.2) | 14/199 (7.0) | 1.11 (0.50 to 2.48) | 0.80 | ||
| Ischaemic stroke | <65 | 82/1602 (5.1) | 121/1649 (7.3) | 0.71 (0.53 to 0.94) | 0.02 | 0.37 |
| 65–80 | 86/1396 (6.2) | 100/1359 (7.4) | 0.81 (0.60 to 1.09) | 0.16 | ||
| ≥80 | 21/207 (10.1) | 17/199 (8.5) | 0.94 (0.45 to 1.95) | 0.86 | ||
| Composite vascular events† | <65 | 100/1602 (5.2) | 146/1649 (8.9) | 0.71 (0.55 to 0.92) | 0.01 | 0.26 |
| 65–80 | 103/1396 (7.4) | 126/1359 (9.3) | 0.75 (0.58 to 0.99) | 0.04 | ||
| ≥80 | 26/207 (12.6) | 21/199 (10.6) | 0.93 (0.47 to 1.83) | 0.83 | ||
| Disabling stroke‡ | <65 | 34/1602 (2.1) | 48/1649 (2.9) | 0.70 (0.45 to 1.10) | 0.12 | 0.07 |
| 65–80 | 46/1396 (3.3) | 32/1359 (2.4) | 1.33 (0.83 to 2.12) | 0.23 | ||
| ≥80 | 17/207 (8.2) | 12/199 (6.0) | 1.00 (0.44 to 2.27) | 0.99 | ||
| Safety outcomes |
0.65 | |||||
| Severe or moderate bleeding | <65 | 2/1602 (0.1) | 5/1649 (0.3) | 0.64 (0.10 to 4.03) | 0.64 | |
| 65–80 | 5/1396 (0.4) | 4/1359 (0.3) | 1.28 (0.30 to 5.48) | 0.74 | ||
| ≥80 | 2/207 (1.0) | 2/199 (1.0) | 0.80 (0.06 to 11.35) | 0.87 | ||
| Any bleeding | <65 | 99/1602 (6.2) | 39/1649 (2.4) | 2.98 (2.02 to 4.40) | <0.0001 | 0.04 |
| 65–80 | 63/1396 (4.5) | 31/1359 (2.3) | 1.95 (1.24 to 3.05) | 0.004 | ||
| ≥80 | 8/207 (3.9) | 10/199 (5.0) | 1.78 (0.48 to 6.66) | 0.39 | ||
| Intracranial haemorrhage | <65 | 1/1602 (0.1) | 4/1649 (0.2) | 0.31 (0.03 to 2.96) | 0.31 | --- |
| 65–80 | 1/1396 (0.1) | 1/1359 (0.1) | --- | --- | ||
| ≥80 | 1/207 (0.5) | 1/199 (0.5) | --- | --- | ||
| Mortality | <65 | 3/1602 (0.2) | 6/1649 (0.4) | 0.27 (0.05 to 1.41) | 0.12 | 0.98 |
| 65–80 | 4/1396 (0.3) | 8/1359 (0.6) | 0.79 (0.20 to 3.16) | 0.73 | ||
| ≥80 | 2/207 (1.0) | 4/199 (2.0) | 0.08 (0.01 to 1.37) | 0.08 |
*Adjusted for sex, medical history (hypertension, diabetes mellitus, dyslipidaemia, previous ischaemic stroke), current smoking and drinking, median time to randomisation, and previous antiplatelet therapy and lipid-lowering therapy.
†Composite vascular events included ischaemic stroke, haemorrhagic stroke, transient ischaemic attack, myocardial infarction or death from vascular causes.
‡A stroke was defined as disabling if the patient had a modified Rankin scale score of >1.