TRA 2°P-TIMI 50

The study was designed to determine whether SCH 530348, when added to the existing standard of care for preventing heart attack and stroke (eg, aspirin, clopidogrel) in patients with a known history of atherosclerosis, will yield additional benefit over the existing standard of care without SCH 530348 in preventing heart attack and stroke. The study was also designed to assess risk of bleeding with SCH 530348 added to the standard of care versus the standard of care alone.

MAIN RESULTS:
Vorapaxar in the secondary prevention of atherothrombotic events

N Engl J Med. 2012 Apr 12;366(15):1404-13.

PRESENTATIONS

PAR-1 Antagonist (ESC 2015)

Scientific Update: Latest Results from TRA 2°P-TIMI 50 (Webcast)

• Vorapaxar in Secondary Prevention (Morrow)
• Insights in Patients with PAD (Bonaca)
• High Risk Patients and Secondary Endpoints (Scirica)

Diabetes (Circulation 2015)
Approval Population (TCT 2014)
Polyvascular Disease (ACC 2013)
Stent Thombosis (AHA 2013)
Peripheral Artery Disease (AHA – ESS 2012)
Stroke (AHA 2012)
TRA2P-TIMI 50 CLI Cart Analysis (Bonaca, AHA 2019)
Lipoprotein(a) and the risk of Major Adverse Limb Events in Patients with Stable Atherosclerotic Vascular Disease (Bonaca, ESC 2023)

OTHER PUBLICATIONS

Evaluation of a novel antiplatelet agent for secondary prevention in patients with a history of atherosclerotic disease: design and rationale for the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2 degrees P)-TIMI 50 trial. Am Heart J. 2009 Sep;158(3):335-341.e3.

Vorapaxar for secondary prevention of thrombotic events for patients with previous myocardial infarction: a prespecified subgroup analysis of the TRA 2 degrees P-TIMI 50 trial. Lancet. 2012 Oct 13;380(9850):1317-24.

Efficacy and safety of vorapaxar in patients with prior ischemic stroke. Stroke. 2013 Mar;44(3):691-8.

Vorapaxar in Patients With Peripheral Artery Disease: Results From TRA 2P-TIMI 50. Circulation. 2013 Apr 9;127(14):1522-9, 1529e1-6.

PAR-1 antagonist vorapaxar favorably improves global thrombotic status in patients with coronary disease. J Thromb Thrombolysis. 2014 Nov;38(4):423-9.

Coronary Stent Thrombosis With Vorapaxar Versus Placebo: Results From the TRA 2 degrees P-TIMI 50 Trial. J Am Coll Cardiol. 2014 Dec 9;64(22):2309-17.

New Ischemic Stroke and Outcomes With Vorapaxar Versus Placebo: Results From the TRA 2 degrees P-TIMI 50 Trial. J Am Coll Cardiol. 2014 Dec 9;64(22):2318-26.

Efficacy and safety of vorapaxar as approved for clinical use in the United States. J Am Heart Assoc. 2015 Mar 19;4(3):e001505.

Efficacy and Safety of Vorapaxar With and Without a Thienopyridine for Secondary Prevention in Patients With Previous Myocardial Infarction and No History of Stroke or Transient Ischemic Attack: Results from TRA 2 degrees P-TIMI 50. Circulation. 2015 Nov 17;132(20):1871-9.

Outcomes in Stable Patients With Previous Atherothrombotic Events Receiving Vorapaxar Who Experience a New Acute Coronary Event (from TRA2 degrees P-TIMI 50). Am J Cardiol. 2016 Apr 1;117(7):1055-8.

Acute Limb Ischemia and Outcomes With Vorapaxar in Patients With Peripheral Artery Disease: Results From the Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis in Myocardial Infarction 50 (TRA2 degrees P-TIMI 50). Circulation. 2016 Mar 8;133(10):997-1005. 

Universal Classification System Type of Incident Myocardial Infarction in Patients With Stable Atherosclerosis: Observations From Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2 degrees P)-TIMI 50. J Am Heart Assoc. 2016 Jul 18;5(7):e003237.

Atherothrombotic Risk Stratification and the Efficacy and Safety of Vorapaxar in Patients With Stable Ischemic Heart Disease and Previous Myocardial Infarction. Circulation. 2016 Jul 26;134(4):304-13.

Vorapaxar in patients with coronary artery bypass grafting: Findings from the TRA 2 degrees P-TIMI 50 trial. Eur Heart J Acute Cardiovasc Care. 2017 Mar;6(2):164-172.

Peripheral Revascularization in Patients With Peripheral Artery Disease With Vorapaxar: Insights From the TRA 2 degrees P-TIMI 50 Trial. JACC Cardiovasc Interv. 2016 Oct 24;9(20):2157-2164.

High-Sensitivity Troponin I in Stable Patients with Atherosclerotic Disease in the TRA 2 degrees P – TIMI 50 Trial. Clin Chem. 2017 Jan;63(1):307-315.

External validation of the TIMI risk score for secondary cardiovascular events among patients with recent myocardial infarction. Atherosclerosis. 2018 May;272:80-86.

Efficacy and safety of more potent antiplatelet therapy with vorapaxar in patients with impaired renal function. J Thromb Thrombolysis. 2019 Apr;47(3):353-360.

Efficacy and safety of vorapaxar for secondary prevention in low body weight in patients with atherosclerosis: analyses from the TRA 2 degrees P-TIMI 50 Trial. Eur Heart J Acute Cardiovasc Care. 2019 Oct 23;2048872619883354.

Effect of vorapaxar on cardiovascular and limb outcomes in patients with peripheral artery disease with and without coronary artery disease: Analysis from the TRA 2 degrees P-TIMI 50 trial. Vasc Med. 2020 Apr;25(2):124-132.

Sex, Permanent Drug Discontinuation, and Study Retention in Clinical Trials: Insights From the TIMI trials. Circulation. 2021 Feb 16;143(7):685-695.

Cardiovascular Biomarkers and Heart Failure Risk in Stable Patients With Atherothrombotic Disease: A Nested Biomarker Study From TRA 2°P-TIMI 50. J Am Heart Assoc. 2021 May 4;10(9):e018673.

Efficacy and Safety of Vorapaxar by Intensity of Background Lipid-Lowering Therapy in Patients With Peripheral Artery Disease: Insights From the TRA2P-TIMI 50 Trial. J Am Heart Assoc. 2021 Oct 8:e021412.

Epidemiology of heart failure hospitalization in patients with stable atherothrombotic disease: Insights from the TRA 2°P-TIMI 50 trial. Clin Cardiol. 2022 Aug;45(8):831-838.

Response to Mei et al. regarding the incidence and predictors of hospitalization for heart failure among patients with stable atherosclerosis in the TRA 2°P-TIMI 50 trial. Clin Cardiol. 2023 Mar;46(3):348-349.