Key result
Prasugrel and ticagrelor reduce cardiovascular events compared to clopidogrel in ACS patients, though differences in trial designs complicate the generalization of mortality results.
Why the study?
Do new oral antiplatelet regimens (prasugrel and ticagrelor) reduce mortality compared to clopidogrel in patients with acute coronary syndromes?
Do new oral antiplatelet regimens (prasugrel and ticagrelor) reduce mortality compared to clopidogrel in patients with acute coronary syndromes?
This review highlights the complexities in generalizing the mortality benefits of newer antiplatelet agents like ticagrelor and prasugrel across all ACS patients due to differences in trial designs and enrolled populations.
Mortality benefits of prasugrel or ticagrelor over clopidogrel remain uncertain across ACS populations; leaves open need for standardized comparative trials.
Acute coronary syndromes (ACS) are the leading cause of mortality in Western countries. Until a few years ago, the antiplatelet drug to be administered in association with aspirin was indisputably clopidogrel. Recent data from randomized trials conducted in ACS patients have shown that the new oral antiplatelet regimens, prasugrel and ticagrelor, are associated with a significant reduction in cardiovascular events, as compared to clopidogrel. Moreover ticagrelor reduced both all-cause and cardiovascular mortality as compared to clopidogrel in the PLATO trial. However, there are intrinsic differences between the trials design and among the enrolled ACS populations, that make complex the generalization of the mortality results in the whole spectrum of ACS patients. We aimed to provide further insights into the unresolved mortality issues raised in the PLATO and TRITON-TIMI 38 trials, by analysing the effects of ticagrelor and prasugrel in the ACS populations included in the respective trials.
No takes yet. Share an insight, caveat, or question.
Servi et al. (2011) conducted a review in Acute coronary syndromes (ACS). Prasugrel and ticagrelor vs. Clopidogrel was evaluated on Mortality. Prasugrel and ticagrelor reduce cardiovascular events compared to clopidogrel in ACS patients, though differences in trial designs complicate the generalization of mortality results.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: