Trial reportThe New England journal of medicine2017
Ticagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease.
2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in The New England journal of medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 187 papers, 23 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
187citing papers in PubMed, 23 pooled it
72.2field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized, Double-blind, Parallel Group, Multicentre Phase IIIb Study to Compare Ticagrelor With Clopidogrel Treatment on the Risk of Cardiovascular Death, Myocardial Infarction and Ischemic Stroke in Patients With Established Peripheral Artery Disease (EUCLID Examining Use of tiCagreLor In paD)
Prehabilitation and Rehabilitation in PAD: A Randomized Exercise Intervention Trial (PREPARE-IT)
Who cites it
187 citing papers in PubMed, 23 syntheses or guidelines pooled it, 621 citations in OpenAlex.
- The bleeding costs of intensive vs. less intensive antithrombotic strategies: a meta-regression analysis.European heart journal. Quality of care & clinical outcomes · 2026Pooled it
- Optimal Antithrombotic Therapy for Peripheral Artery Disease: A Systematic Review and Network Meta-Analysis.Journal of the American Heart Association · 2026Pooled it
- CYP2C19 genotype testing for clopidogrel: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).British journal of clinical pharmacology · 2026Guideline
- Pooled it
- Non-surgical interventions for preventing contralateral tissue loss and amputation in dysvascular patients with a primary major lower limb amputation.The Cochrane database of systematic reviews · 2024Pooled it
- 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Prophylactic Efficacy and Safety of Antithrombotic Regimens in Patients with Stable Atherosclerotic Cardiovascular Disease (S-ASCVD): A Bayesian Network Meta-Regression Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023Pooled it
- Hypoglycemia as a potential risk for patients taking clopidogrel: A systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Pooled it
- Antiplatelet agents for chronic kidney disease.The Cochrane database of systematic reviews · 2022Pooled it
- What Went Wrong with VEGF-A in Peripheral Arterial Disease? A Systematic Review and Biological Insights on Future Therapeutics.Journal of vascular research · 2022Pooled it
- Secondary prevention of antithrombotic therapy in patients with stable cardiovascular disease at high ischemic risk: A network meta-analysis of randomized controlled trials.Frontiers in cardiovascular medicine · 2022Pooled it
- The efficacy and safety of direct oral anticoagulants plus aspirin in symptomatic lower extremity peripheral arterial disease: a systematic review and meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis · 2021Pooled it
- Efficacy and Safety of Antiplatelet Therapies in Symptomatic Peripheral Artery Disease: A Systematic Review and Network Meta-Analysis.Current vascular pharmacology · 2021Pooled it
- Ticagrelor for the primary prevention of stroke in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis · 2020Pooled it
- Mortality and Paclitaxel-Coated Devices: An Individual Patient Data Meta-Analysis.Circulation · 2020Pooled it
- The risk of dyspnea in patients treated with third-generation P2YBMC cardiovascular disorders · 2020Pooled it
- Antithrombotic Treatments in Patients with Chronic Coronary Artery Disease or Peripheral Artery Disease: A Systematic Review of Randomised Controlled Trials.Cardiovascular therapeutics · 2020Pooled it
- Short-term dual antiplatelet therapy (DAPT) followed by P2Y12 monotherapy versus traditional DAPT in patients undergoing percutaneous coronary intervention: meta-analysis and viewpoint.Journal of thrombosis and thrombolysis · 2020Pooled it
127 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors at 10 institutions in 5 countries.
William R HiattFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
F Gerry R FowkesFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Gretchen HeizerFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Jeffrey S BergerFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Iris BaumgartnerFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Peter HeldFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Brian G KatonaFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Kenneth W MahaffeyFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Lars NorgrenFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
W Schuyler JonesFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Juuso BlomsterFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Marcus MillegårdFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Craig ReistFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
Manesh R PatelFrom the University of Colorado School of Medicine and CPC Clinical Research, Aurora (W.R.H.); Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh (F.G.R.F.); Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (G.H., W.S.J., C.R., M.R.P.); the Departments of Medicine and Surgery, New York University School of Medicine, New York (J.S.B.); Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (I.B.); AstraZeneca Gothenburg, Mölndal (P.H., J.B., M.M.), and Faculty of Medicine and Health, Örebro University, Örebro (L.N.) - both in Sweden; AstraZeneca Gaithersburg, Gaithersburg, MD (B.G.K.); and Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA (K.W.M.).
EUCLID Trial Steering Committee and Investigators
AstraZeneca (Netherlands) · NLClinical Research Institute · USDuke University · USAstraZeneca (United States) · USCenter for Clinical Research (United States) · USNew York University · USÖrebro University · SEUniversity of Bern · CHUniversity of Colorado Denver · USUniversity of Edinburgh · GB
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeripheral artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. We wanted to compare clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with peripheral artery disease.
methodsIn this double-blind, event-driven trial, we randomly assigned 13,885 patients with symptomatic peripheral artery disease to receive monotherapy with ticagrelor (90 mg twice daily) or clopidogrel (75 mg once daily). Patients were eligible if they had an ankle-brachial index (ABI) of 0.80 or less or had undergone previous revascularization of the lower limbs. The primary efficacy end point was a composite of adjudicated cardiovascular death, myocardial infarction, or ischemic stroke. The primary safety end point was major bleeding. The median follow-up was 30 months.
resultsThe median age of the patients was 66 years, and 72% were men; 43% were enrolled on the basis of the ABI and 57% on the basis of previous revascularization. The mean baseline ABI in all patients was 0.71, 76.6% of the patients had claudication, and 4.6% had critical limb ischemia. The primary efficacy end point occurred in 751 of 6930 patients (10.8%) receiving ticagrelor and in 740 of 6955 (10.6%) receiving clopidogrel (hazard ratio, 1.02; 95% confidence interval [CI], 0.92 to 1.13; P=0.65). In each group, acute limb ischemia occurred in 1.7% of the patients (hazard ratio, 1.03; 95% CI, 0.79 to 1.33; P=0.85) and major bleeding in 1.6% (hazard ratio, 1.10; 95% CI, 0.84 to 1.43; P=0.49).
conclusionsIn patients with symptomatic peripheral artery disease, ticagrelor was not shown to be superior to clopidogrel for the reduction of cardiovascular events. Major bleeding occurred at similar rates among the patients in the two trial groups. (Funded by AstraZeneca; EUCLID ClinicalTrials.gov number, NCT01732822 .).
Indexed as
AdenosineAgedCardiovascular DiseasesClopidogrelDouble-Blind MethodFemaleHemorrhageHumansIntermittent ClaudicationIschemiaKaplan-Meier EstimateLegMaleMiddle AgedPeripheral Arterial DiseasePlatelet Aggregation InhibitorsAdenosineClopidogrelPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsTicagrelorTiclopidine
Identifiers
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Registered trials
NCT01732822ClinicalTrials.gov
NCT06566976ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.