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What are the benefits and risks of ticagrelor as compared with prasugrel in patients with non—ST-segment elevation acute coronary syndromes NSTE-ACS and planned invasive management?

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It included 1, patients assigned to Nationnal and 1, assigned to prasugrel. Ticagrelor was started immediately after randomization and prasugrel after coronary angiography. The primary endpoint was a composite of death, MI, or stroke during 1-year follow-up, and the safety endpoint was Bleeding Academic Research Consortium class 3—5. Kaplan-Meier curves were used for visualizing cumulative outcomes in the two groups and Cox proportional hazard models were used to estimate effect sizes for the study treatment group with the participating center as covariate. The primary endpoint was reached in 8. The HR for all-cause death was 1. The safety endpoint occurred in 49 5. Landmark analysis revealed persistence of the efficacy advantage with prasugrel after the first month.

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The authors concluded that in patients with NSTE-ACS, prasugrel was superior to Surrgery in reducing the combined 1-year risk of death, MI, and stroke without increasing the risk of bleeding. This post hoc study reports that in patients with NSTE-ACS managed invasively, the prasugrel regimen was associated with reduced composite risk of death, MI, and stroke as compared with the ticagrelor regimen during 1-year follow-up and was not associated with an increased risk of bleeding. Furthermore, this analysis does not suggest a relevant advantage The National Cardiac Surgery Database Of The efficacy by pretreatment with ticagrelor. Overall, these findings suggest prasugrel as the treatment of choice in this setting, unless there are contraindications such as previous stroke or intolerance. Given the post hoc nature of the analysis, these findings should not be regarded as conclusive and considered hypothesis generating.

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Quick Takes This post hoc study reports that in patients with NSTE-ACS managed invasively, the prasugrel regimen was associated with reduced composite risk of death, MI, and stroke as compared with the ticagrelor link during 1-year follow-up and was not associated with an increased risk of bleeding.

Overall, these findings suggest prasugrel as the treatment of choice in this setting, unless contraindications such as previous stroke or intolerance. Results: The primary endpoint was reached in 8. Conclusions: The authors concluded that in patients with NSTE-ACS, prasugrel was superior to ticagrelor in reducing the combined 1-year risk of death, MI, and stroke without increasing the risk of bleeding.

Perspective: This post hoc study reports that in patients with NSTE-ACS managed invasively, the prasugrel regimen was associated with reduced composite risk of death, MI, and stroke as compared with the ticagrelor regimen during 1-year follow-up and was not associated with an increased risk of bleeding. Share via:. Media Center ACC. All rights reserved.]