WEDNESDAY, May 21 (HealthDay News) -- Among patients with acute coronary syndrome treated with percutaneous coronary intervention (PCI), the new antiplatelet agent prasugrel appears to be superior to clopidogrel during the acute phase as well as over the weeks and months that follow, according to an article published in the May 27 issue of the Journal of the American College of Cardiology.
Elliott M. Antman, M.D., of Brigham and Women's Hospital in Boston, and colleagues analyzed data from the TRITON-TIMI 38 trial, which randomized 13,608 patients with acute coronary syndrome undergoing PCI to receive either clopidogrel or prasugrel, performing efficacy and net clinical benefit analyses from randomization to day 3 and from day 3 until the end of the trial (median 15 months) in order to evaluate the relative contribution of loading and maintenance doses of prasugrel on the reduced cardiovascular event rates observed with prasugrel in the trial.
Prasugrel was associated with a significant reduction in myocardial infarction, stent thrombosis and urgent target vessel revascularization during both time periods, the researchers report. While rates of major bleeding were similar to clopidogrel during the first three days, the rates were greater during the remainder of the trial, they note. However, net clinical benefit analysis favored prasugrel over clopidogrel, the report indicates.
"The net clinical benefit composite end point was significantly in favor of prasugrel both during the first three days and from three days to the end of the study," the authors conclude.
This trial was supported by Daiichi Sankyo Pharma and Eli Lilly and Co., and one study author is employed by Eli Lilly.
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