Key result
Pre-hospital initiation of prasugrel compared to clopidogrel in STEMI patients was associated with a MACE rate of 1.6% vs 2.3% (adjusted OR 0.749; 95% CI 0.285-1.968) and greater ST resolution.
Why the study?
Does pre-hospital initiation of prasugrel compared to clopidogrel improve clinical and angiographic outcomes in STEMI patients undergoing primary angioplasty?
Population
2053 ST-segment elevation myocardial infarction patients undergoing primary angioplasty, enrolled in a…
Comparison
Pre-hospital initiation of prasugrel vs Pre-hospital initiation of clopidogrel
Design
Cohort
Follow-up
in-hospital
Authors
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May improve ST resolution without excess MACE or bleeding in STEMI; hypothesis-generating and requires randomized confirmation.
Observational (n=2,053)
Yes
Does pre-hospital initiation of prasugrel compared to clopidogrel improve clinical and angiographic outcomes in STEMI patients undergoing primary angioplasty?
Odds Ratio: 0.749 (95% CI 0.285–1.968)
Absolute Event Rate: 1.6% vs 2.3%
Pre-hospital loading with prasugrel in STEMI patients is associated with better post-PCI ST-segment resolution compared to clopidogrel, without an increase in bleeding or MACE, though switching between agents is common.
Clemmensen et al. (2014) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=2,053). Pre-hospital initiation of prasugrel vs. Pre-hospital initiation of clopidogrel was evaluated on Major adverse cardiac events (MACE) (adjusted OR 0.749, 95% CI 0.285-1.968). Pre-hospital initiation of prasugrel compared to clopidogrel in STEMI patients was associated with a MACE rate of 1.6% vs 2.3% (adjusted OR 0.749; 95% CI 0.285-1.968) and greater ST resolution.
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