The benefits of ticagrelor in PLATO appeared within the first 30 days, persisted for up to 360 days, and were evident irrespective of clopidogrel pretreat- ment and whether patients had invasive or medical man- agement planned. Notably, ticagrelor was associated with a 1.4% absolute reduction in all-cause mortality (4.5% lower rates of definite stent thrombosis (1.3% versus 1.90%; HR: 0.67; 95% CI: 0.50 to 0.91). There were no significant differences between the ticagre- lor and clopidogrel groups in rates of major bleeding (the primary safety endpoint: composite of major life-threatening and other major bleeding events, PLATO study criteria; CI: 0.48 to 1.59).9 There were also no differences in major bleeding in patients undergoing CABG, in whom clopidogrel and ticagrelor were discontinued before the procedure for 5 days and 24 to 72 hours, respectively, per study protocol. Ticagrelor, however, was associated with a higher rate of non CABG-related major bleeding (4.5% versus 3.8%, P 0.03). In addition, ticagrelor caused a higher incidence of 2.02; although not necessitating drug discontinuation except in a few cases), mild increases in creatinine and uric acid levels, and a higher rate of ventricular pauses 3 seconds in the first week (5.8% versus 3.6%, P 0.01; but without causing differences in syncope or pacemaker implantation). Overall, discontinuation of the study drug due to adverse events occurred more frequently with ticagrelor than with clopidogrel (7.4% versus 6.0%; P 0.001). Patients with a history of bleeding were excluded in PLATO, and 4% of patients had a prior history of nonhemorrhagic stroke.9 The efficacy and safety of ticagrelor in patients with prior tran- sient ischemic attack or stroke were not reported in PLATO,9 and the balance of risks and benefits of ticagrelor in this patient population remains unclear. 