Related Experiment Video
Updated: Oct 7, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Real-life data for major adverse cardiac events in patients with ST-elevation myocardial infarction prasugrel versus
M H Satilmisoglu1, M Gul2, S Ozyilmaz3
1Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. drmg23@gmail.com.
Insights
Prasugrel and ticagrelor show similar effectiveness for major adverse cardiac events in ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). However, prasugrel was associated with fewer treatment discontinuations and better tolerability compared to ticagrelor.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- ST-segment-elevation myocardial infarction (STEMI) is a critical condition requiring prompt intervention.
- Oral antiplatelet therapy is essential post-percutaneous coronary intervention (PCI) to prevent thrombotic events.
- Prasugrel and ticagrelor are P2Y12 inhibitors used in STEMI patients, with differing clinical profiles.
Purpose of the Study:
- To compare the efficacy and safety of prasugrel versus ticagrelor in STEMI patients undergoing primary PCI.
- To evaluate major adverse cardiac events (MACE) and other clinical outcomes between the two antiplatelet agents.
- To assess treatment discontinuation rates and reasons, particularly dyspnea-related, between prasugrel and ticagrelor.
Main Methods:
- A prospective comparative study included 560 STEMI patients suitable for PCI.
- Patients received either prasugrel (n=232) or ticagrelor (n=328) as oral antiplatelet therapy.
- Follow-up averaged 10.9 months for prasugrel and 11.9 months for ticagrelor, monitoring MACE, mortality, bleeding, and stent thrombosis.
Main Results:
- Major adverse cardiac events occurred at similar rates: 7.3% for prasugrel vs. 7.9% for ticagrelor (p=0.793).
- Mortality rates were higher in the ticagrelor group (6.7%) but not statistically significant compared to prasugrel (3.4%, p=0.092).
- Treatment discontinuation was significantly higher with ticagrelor (14.3%) vs. prasugrel (8.6%, p=0.023), primarily due to dyspnea in the ticagrelor group (p=0.001).
Conclusions:
- Prasugrel and ticagrelor demonstrate comparable efficacy in preventing MACE in STEMI patients post-PCI.
- Prasugrel exhibits superior tolerability, leading to significantly lower treatment discontinuation rates compared to ticagrelor.
- The findings suggest prasugrel may be a preferred option when long-term adherence is a concern due to side effects like dyspnea.
Abstract:
We aimed to evaluate the major adverse cardiac events and other clinical outcomes in ST-segment-elevation myocardial infarction (STEMI) cases treated with prasugrel versus ticagrelor after percutaneous intervention (PCI). The study was a prospective comparative study into which 560 patients diagnosed with STEMI, being suitable for PCI, and prescribed with either prasugrel (n = 232) or ticagrelor (n = 328) as oral antiplatelet therapy were included. Patients were followed up for a mean of 10.9 ± 4.7 months and 11.9 ± 4.9 months for prasugrel and ticagrelor groups, respectively. The major adverse cardiac events developed in similar rates between prasugrel and ticagrelor groups (7.3% versus 7.9%, respectively, p = 0.793). Even if mortality rate was higher in ticagrelor group, the difference did not reach statistically significance (3.4% vs. 6.7%, p=0.092). Among all study population, stent thrombosis and minor bleeding was recorded only in 7 (1.2%) and 12 (2.1%) patients without significant difference between prasugrel and ticagrelor groups. Twenty patients (8.6%) in prasugrel group and 47 patients (14.3%) in ticagrelor group discontinued treatment (p = 0.023). In ticagrelor group, 12 patients discontinued treatment due to dyspnea, but none in prasugrel group (p = 0.001). Prasugrel and ticagrelor have similar effects on major adverse cardiac events in patients with STEMI undergoing primary PCI, but prasugrel seems more tolerated and less discontinued than ticagrelor.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:19Pharmacovigilance
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...