Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization

Abstract

Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

“…end point of cardiovascular death, MI, and stroke was reported between treatment with prasugrel or clopidogrel. 27 None of the safety end points was s ignificantly different between the two study groups.…”

“…26 The second major phase III study in which prasugrel was compared with clopidogrel was the TRILOGY ACS trial. 27 This trial included a population of 9,326 patients with ACS who were being medically managed. The daily dose of prasugrel was reduced to 5 mg (instead of 10 mg) for patients aged ≥75 years and those with a body mass <60 kg.…”

How to manage prasugrel and ticagrelor in daily practice

“…In the TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) trial [25], prasugrel showed no benefits over clopidogrel in reducing death from cardiovascular causes, myocardial infarction or stroke among patients with ACS who were not undergoing PCI.…”

Recovery free of heart failure after acute coronary syndrome and coronary revascularization

“…Given the prevalence of ischaemic heart disease, previous studies have largely examined prognostic risk factors for the development of HF subsequent to acute coronary syndrome (ACS) 3, 4. To that effect, surgical revascularization in the form of coronary artery bypass grafting (CABG) surgery remains an important treatment modality for patients suffering from ACS 5.…”