Ticagrelor vs. prasugrel for severe heart attack patients undergoing PCI
When ST-segment–elevation myocardial infarction (STEMI) patients undergo percutaneous coronary intervention (PCI), they are typically treated with dual antiplatelet therapy that includes aspirin and clopidogrel. For some patients, however, this can lead to a significant increase in the risk of atherothrombotic events.
Previous studies have concluded that treating these patients with prasugrel or ticagrelor—two newer P2Y12 inhibitors—may improve outcomes. But is one of those drugs better than the other for STEMI patients? A team of researchers tracked relevant data from the ISAR REACT-5 trial to find out, sharing their findings in Circulation.
Overall, the team explored data from more than 1,600 STEMI patients who underwent primary PCI. The primary endpoint was death, myocardial infarction or a stroke within one year. While 10.1% of the ticagrelor group reached that endpoint, that number was 7.9% for patients in the prasugrel group. There was no significant difference in the rates of all-cause mortality, stroke or definite stent thrombosis between the two groups.
The myocardial infarction rate in that first year was higher for the ticagrelor group (5.3%) than the prasugrel group (2.8%), the team added.
“Although overall efficacy of both drugs was not significantly different, the advantage observed with prasugrel in terms of the risk of recurrent myocardial infarction might be considered in the treatment of patients with STEMI undergoing primary PCI who present with a particularly higher risk for thrombotic complications,” wrote lead author Alp Aytekin, of the German Heart Center in Munich, Germany, and colleagues.
The full Circulation study can be read here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.