Prasugrel Versus Ticagrelor in Patients With Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: Multicenter Randomized PRAGUE-18 Study
No randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher efficacy of these newer P2Y inhibitors were first demonstrated relative to clopidogrel. This academic study was designed to compare the efficacy and safety...
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| Veröffentlicht in: | Circulation (New York, N.Y.) Jg. 134; H. 21; S. 1603 - 1612 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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United States
22.11.2016
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| ISSN: | 1524-4539 |
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| Abstract | No randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher efficacy of these newer P2Y
inhibitors were first demonstrated relative to clopidogrel.
This academic study was designed to compare the efficacy and safety of prasugrel and ticagrelor in acute myocardial infarction treated with primary or immediate percutaneous coronary intervention. A total of 1230 patients were randomly assigned across 14 sites to either prasugrel or ticagrelor, which was initiated before percutaneous coronary intervention. Nearly 4% were in cardiogenic shock, and 5.2% were on mechanical ventilation. The primary end point was defined as death, reinfarction, urgent target vessel revascularization, stroke, or serious bleeding requiring transfusion or prolonging hospitalization at 7 days (to reflect primarily the in-hospital phase). This analysis presents data from the first 30 days (key secondary end point). The total follow-up will be 1 year for all patients and will be completed in 2017.
The study was prematurely terminated for futility. The occurrence of the primary end point did not differ between groups receiving prasugrel and ticagrelor (4.0% and 4.1%, respectively; odds ratio, 0.98; 95% confidence interval, 0.55-1.73; P=0.939). No significant difference was found in any of the components of the primary end point. The occurrence of key secondary end point within 30 days, composed of cardiovascular death, nonfatal myocardial infarction, or stroke, did not show any significant difference between prasugrel and ticagrelor (2.7% and 2.5%, respectively; odds ratio, 1.06; 95% confidence interval, 0.53-2.15; P=0.864).
This head-to-head comparison of prasugrel and ticagrelor does not support the hypothesis that one is more effective or safer than the other in preventing ischemic and bleeding events in the acute phase of myocardial infarction treated with a primary percutaneous coronary intervention strategy. The observed rates of major outcomes were similar but with broad confidence intervals around the estimates. These interesting observations need to be confirmed in a larger trial.
URL: http://www.ClinicalTrials.gov. Unique identifier: NCT02808767. |
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| AbstractList | BACKGROUNDNo randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher efficacy of these newer P2Y12 inhibitors were first demonstrated relative to clopidogrel.METHODSThis academic study was designed to compare the efficacy and safety of prasugrel and ticagrelor in acute myocardial infarction treated with primary or immediate percutaneous coronary intervention. A total of 1230 patients were randomly assigned across 14 sites to either prasugrel or ticagrelor, which was initiated before percutaneous coronary intervention. Nearly 4% were in cardiogenic shock, and 5.2% were on mechanical ventilation. The primary end point was defined as death, reinfarction, urgent target vessel revascularization, stroke, or serious bleeding requiring transfusion or prolonging hospitalization at 7 days (to reflect primarily the in-hospital phase). This analysis presents data from the first 30 days (key secondary end point). The total follow-up will be 1 year for all patients and will be completed in 2017.RESULTSThe study was prematurely terminated for futility. The occurrence of the primary end point did not differ between groups receiving prasugrel and ticagrelor (4.0% and 4.1%, respectively; odds ratio, 0.98; 95% confidence interval, 0.55-1.73; P=0.939). No significant difference was found in any of the components of the primary end point. The occurrence of key secondary end point within 30 days, composed of cardiovascular death, nonfatal myocardial infarction, or stroke, did not show any significant difference between prasugrel and ticagrelor (2.7% and 2.5%, respectively; odds ratio, 1.06; 95% confidence interval, 0.53-2.15; P=0.864).CONCLUSIONSThis head-to-head comparison of prasugrel and ticagrelor does not support the hypothesis that one is more effective or safer than the other in preventing ischemic and bleeding events in the acute phase of myocardial infarction treated with a primary percutaneous coronary intervention strategy. The observed rates of major outcomes were similar but with broad confidence intervals around the estimates. These interesting observations need to be confirmed in a larger trial.CLINICAL TRIAL REGISTRATIONURL: http://www.ClinicalTrials.gov. Unique identifier: NCT02808767. No randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher efficacy of these newer P2Y inhibitors were first demonstrated relative to clopidogrel. This academic study was designed to compare the efficacy and safety of prasugrel and ticagrelor in acute myocardial infarction treated with primary or immediate percutaneous coronary intervention. A total of 1230 patients were randomly assigned across 14 sites to either prasugrel or ticagrelor, which was initiated before percutaneous coronary intervention. Nearly 4% were in cardiogenic shock, and 5.2% were on mechanical ventilation. The primary end point was defined as death, reinfarction, urgent target vessel revascularization, stroke, or serious bleeding requiring transfusion or prolonging hospitalization at 7 days (to reflect primarily the in-hospital phase). This analysis presents data from the first 30 days (key secondary end point). The total follow-up will be 1 year for all patients and will be completed in 2017. The study was prematurely terminated for futility. The occurrence of the primary end point did not differ between groups receiving prasugrel and ticagrelor (4.0% and 4.1%, respectively; odds ratio, 0.98; 95% confidence interval, 0.55-1.73; P=0.939). No significant difference was found in any of the components of the primary end point. The occurrence of key secondary end point within 30 days, composed of cardiovascular death, nonfatal myocardial infarction, or stroke, did not show any significant difference between prasugrel and ticagrelor (2.7% and 2.5%, respectively; odds ratio, 1.06; 95% confidence interval, 0.53-2.15; P=0.864). This head-to-head comparison of prasugrel and ticagrelor does not support the hypothesis that one is more effective or safer than the other in preventing ischemic and bleeding events in the acute phase of myocardial infarction treated with a primary percutaneous coronary intervention strategy. The observed rates of major outcomes were similar but with broad confidence intervals around the estimates. These interesting observations need to be confirmed in a larger trial. URL: http://www.ClinicalTrials.gov. Unique identifier: NCT02808767. |
| Author | Hromadka, Milan Kramarikova, Petra Cervinka, Pavel Miklik, Roman Majtan, Bohumil Mrozek, Jan Tousek, Frantisek Ostransky, Jiri Widimsky, Petr Knot, Jiri Jarkovsky, Jiri Motovska, Zuzana Rokyta, Richard Hlinomaz, Ota Simek, Stanislav Dusek, Jaroslav Kala, Petr Varvarovsky, Ivo Branny, Marian |
| Author_xml | – sequence: 1 givenname: Zuzana surname: Motovska fullname: Motovska, Zuzana email: motovska.zuzana@gmail.com organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.). motovska.zuzana@gmail.com – sequence: 2 givenname: Ota surname: Hlinomaz fullname: Hlinomaz, Ota organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 3 givenname: Roman surname: Miklik fullname: Miklik, Roman organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 4 givenname: Milan surname: Hromadka fullname: Hromadka, Milan organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 5 givenname: Ivo surname: Varvarovsky fullname: Varvarovsky, Ivo organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 6 givenname: Jaroslav surname: Dusek fullname: Dusek, Jaroslav organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 7 givenname: Jiri surname: Knot fullname: Knot, Jiri organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 8 givenname: Jiri surname: Jarkovsky fullname: Jarkovsky, Jiri organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 9 givenname: Petr surname: Kala fullname: Kala, Petr organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 10 givenname: Richard surname: Rokyta fullname: Rokyta, Richard organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 11 givenname: Frantisek surname: Tousek fullname: Tousek, Frantisek organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 12 givenname: Petra surname: Kramarikova fullname: Kramarikova, Petra organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 13 givenname: Bohumil surname: Majtan fullname: Majtan, Bohumil organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 14 givenname: Stanislav surname: Simek fullname: Simek, Stanislav organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 15 givenname: Marian surname: Branny fullname: Branny, Marian organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 16 givenname: Jan surname: Mrozek fullname: Mrozek, Jan organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. 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Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 17 givenname: Pavel surname: Cervinka fullname: Cervinka, Pavel organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. 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Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 18 givenname: Jiri surname: Ostransky fullname: Ostransky, Jiri organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. Kramarikova); Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic (R.M., P. Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) – sequence: 19 givenname: Petr surname: Widimsky fullname: Widimsky, Petr organization: From Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.M., J.K., P.W.); First Department of Internal Medicine-Cardioangiology, ICRC, Faculty of Medicine of Masaryk University and St. Anne's University Hospital, Brno, Czech Republic (O.H., P. 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Kala); Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic (M.H., R.R.); Cardiology Centre AGEL, Pardubice, Czech Republic (I.V.); First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic (J.D.); Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic (J..J.); Cardiocenter, Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic (F.T.); Cardiocenter, Regional Hospital, Karlovy Vary, Czech Republic (B.M.); Cardiocenter, Hospital Na Homolce, Prague, Czech Republic (B.M.); Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic (S.S.); AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic (M.B.); Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic (J.M.); Department of Cardiology, Krajska zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic (P.C.); and First Internal Cardiology Clinic, University Hospital Olomouc, Olomouc, Czech Republic (J.O.) |
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| Keywords | percutaneous coronary intervention ticagrelor prasugrel hydrochloride treatment outcome safety myocardial infarction |
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| PublicationTitle | Circulation (New York, N.Y.) |
| PublicationTitleAlternate | Circulation |
| PublicationYear | 2016 |
| References | 28396382 - Circulation. 2017 Apr 11;135(15):e885-e886 28396383 - Circulation. 2017 Apr 11;135(15):e887-e888 27881505 - Circulation. 2016 Nov 22;134(21):1613-1616 |
| References_xml | – reference: 27881505 - Circulation. 2016 Nov 22;134(21):1613-1616 – reference: 28396383 - Circulation. 2017 Apr 11;135(15):e887-e888 – reference: 28396382 - Circulation. 2017 Apr 11;135(15):e885-e886 |
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| Snippet | No randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher efficacy of... BACKGROUNDNo randomized head-to-head comparison of the efficacy and safety of ticagrelor and prasugrel has been published in the 7 years since the higher... |
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| SubjectTerms | Adenosine - administration & dosage Adenosine - analogs & derivatives Adenosine - therapeutic use Adult Aged Female Humans Middle Aged Myocardial Infarction - drug therapy Myocardial Infarction - pathology Myocardial Infarction - therapy Percutaneous Coronary Intervention - methods Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - therapeutic use Prasugrel Hydrochloride - administration & dosage Prasugrel Hydrochloride - therapeutic use Ticagrelor |
| Title | Prasugrel Versus Ticagrelor in Patients With Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: Multicenter Randomized PRAGUE-18 Study |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/27576777 https://www.proquest.com/docview/1843965179 |
| Volume | 134 |
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