Key result
Low recruitment centers yielded similar rates of death, MI, or stroke compared to high recruitment centers (7.3% vs 8.4%; P=0.267), but lower 1-year all-cause mortality (2.9% vs 4.5%; P=0.031).
Why the study?
It remained unknown whether differences exist in risk profile and treatment effect between patients recruited in low- versus high-recruitment centers in a randomized multicenter trial.
Does patient recruitment volume (low vs high recruitment centers) impact risk profile, outcomes, and treatment effect of ticagrelor versus prasugrel in patients with acute coronary syndrome?
Population
4018 patients with acute coronary syndrome recruited in the ISAR-REACT 5 trial
Comparison
Low recruitment centers vs high recruitment centers
Design
Multicenter randomized trial post-hoc / subgroup analysis
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Ticagrelor-prasugrel effects appear consistent across recruitment volumes; leaves open center influences on risk profiles and mortality.
RCT (n=4,018)
randomized
Yes
Does patient recruitment volume (low vs high recruitment centers) impact risk profile, outcomes, and treatment effect of ticagrelor versus prasugrel in patients with acute coronary syndrome?
Absolute Event Rate: 7.3% vs 8.4%
p-value: p=0.267
In a multicenter ACS trial, patient recruitment volume did not interact with the treatment effect of ticagrelor versus prasugrel, although low-recruiting centers enrolled patients with more favorable risk profiles and lower 1-year mortality.
A 2021 study conducted an RCT in acute coronary syndrome (n=4,018). Low recruitment center (LRC) vs. High recruitment center (HRC) was evaluated on composite of all-cause death, myocardial infarction, or stroke (p=0.267). Low recruitment centers yielded similar rates of death, MI, or stroke compared to high recruitment centers (7.3% vs 8.4%; P=0.267), but lower 1-year all-cause mortality (2.9% vs 4.5%; P=0.031).
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