Ticagrelor versus Adjusted‐Dose Prasugrel in Acute Coronary Syndrome with Percutaneous Coronary Intervention

Dual antiplatelet therapy (DAPT) with ticagrelor or adjusted‐dose prasugrel has been used for acute coronary syndrome (ACS). However, few studies have directly compared these two drugs. In this study, we compared the real‐world applications and outcomes of these two drugs in patients with ACS who ha...

Full description

Saved in:
Bibliographic Details
Published in:Clinical pharmacology and therapeutics Vol. 116; no. 3; pp. 747 - 756
Main Authors: Tsai, Ming‐Lung, Lin, Yuan, Chen, Dong‐Yi, Lin, Ming‐Shyan, Wang, Chao‐Yung, Hsieh, I‐Chang, Yang, Ning‐I, Hung, Ming‐Jui, Chen, Tien‐Hsing
Format: Journal Article
Language:English
Published: United States 01.09.2024
Subjects:
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - therapy
Aged
Female
Hemorrhage - chemically induced
Hemorrhage - epidemiology
Humans
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects
Platelet Aggregation Inhibitors - administration & dosage
Platelet Aggregation Inhibitors - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Prasugrel Hydrochloride - administration & dosage
Prasugrel Hydrochloride - adverse effects
Prasugrel Hydrochloride - therapeutic use
Retrospective Studies
Ticagrelor - administration & dosage
Ticagrelor - adverse effects
Ticagrelor - therapeutic use
Treatment Outcome
ISSN:0009-9236, 1532-6535, 1532-6535
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Dual antiplatelet therapy (DAPT) with ticagrelor or adjusted‐dose prasugrel has been used for acute coronary syndrome (ACS). However, few studies have directly compared these two drugs. In this study, we compared the real‐world applications and outcomes of these two drugs in patients with ACS who had undergone percutaneous coronary intervention (PCI). This retrospective cohort study was conducted using the data of eligible patients with ACS who had undergone PCI at Chang Gung Memorial Hospital System between June 2019 and December 2021. The primary efficacy‐related outcome was the occurrence of major adverse cardiovascular events (MACEs), and the primary safety‐related outcome was major bleeding. Inverse probability of treatment weighting based on propensity score was performed to reduce confounding effects. The study included 2,636 patients; of them, 429 received prasugrel and 2,207 received ticagrelor. No significant between‐group difference was observed in the risk of MACE (13.1 vs. 13.1 events per 100 person‐years, respectively, hazard ratio (HR): 1.01, 95% confidence interval (CI): 0.71–1.43). Both groups exhibited similar rates of major bleeding (3.9 vs. 4.1 events per 100 person‐years, respectively, subdistribution HR: 0.96, 95% CI: 0.68–1.35). In real‐world settings, adjusted‐dose prasugrel and ticagrelor exhibit comparable safety and efficacy profiles in East Asian patients with ACS after PCI. Our findings offer valuable insights for future clinical decision making and patient management strategies.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0009-9236
1532-6535
1532-6535
DOI:10.1002/cpt.3209