The rate of death, myocardial infarction or stroke was significantly reduced at 1 year with Effient compared with Brilinta in patients with acute coronary syndrome, with or without ST-segment elevation, according to trial results presented at the European Society of Cardiology Congress.
The trial included 4,018 patients (mean age, 64 years; 23.8% were women) treated at European centers. They were randomly assigned to receive either a 180 mg loading dose of
Brilinta (ticagrelor, AstraZeneca), then a maintenance dose of 90 mg twice daily, or a 60 mg loading dose of Effient (prasugrel, Daiichi Sankyo/Eli Lilly) then a maintenance dose of 10 mg once daily. The timing of prasugrel initiation was based on clinical presentation.
“A particular feature of this trial is that it did not simply compare two antiplatelet drugs.
Rather, it compared two antiplatelet treatment strategies involving two different drugs,”
Stefanie Schüpke , MD, from Deutsches Herzzentrum München in Munich, and colleagues wrote in a New England Journal of Medicine article that was published in conjunction with the meeting.
According to researchers, a composite outcome of death, myocardial infarction or stroke at 1 year occurred in 9.3% of patients who received ticagrelor vs. 6.9% who received prasugrel (HR = 1.36; 95% CI, 1.09-1.7). Comparisons of each individual outcome yielded similar results.
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Schüpke S. Hot Line Session 2. Presented at: European Society of Cardiology Congress; Aug. 31-Sept. 4, 2019; Paris.
Schüpke S, et al. N Engl J Med. 2019;doi:10.1056/NEJMoa1908973.
Disclosure: Schüpke reports receiving support from the DZHK (German Center for Cardiovascular Research) for ISAR-REACT 5 and consulting fees from Bayer Vital GmbH.