Author + information
- Jeong Cheon Choe,
- Lee Sun Hack,
- Jinhee Ahn,
- Jin Sup Park,
- Hye Won Lee,
- Jun-Hyok Oh,
- Jung Hyun Choi,
- Han Cheol Lee,
- Kwang Soo Cha and
- Taek Jong Hong
Background: In acute coronary syndrome (ACS) patients following percutaneous coronary intervention (PCI), ticagrelor or prasugrel are increasingly used, but limited data are available on the safety and efficacy of ticagrelor vs. prasugrel use in real world practice. We compared bleeding rates and clinical outcomes after ticagrelor vs. prasugrel use in these patients.
Methods: Among 12432 patients enrolled in a nationwide, prospective, multicenter registry, we studied 2611 ACS patients following PCI and whom prescribed ticagrelor (n=1474) or prasugrel (n=1137). Bleeding and major adverse cardiac events (MACE; cardiac death, re-myocardial infarction, or stroke) were compared in entire and propensity score (PS)-matched cohorts.
Results: Bleeding occurred in 198 patients (7.6%) and was not significantly different in the ticagrelor vs. prasugrel groups (all: 7.3% vs. 7.9%, p=0.129; PS-matched: n=1052, 7.6% vs. 7.6%, p=0.581; odds ratio 0.69, 95% confidence interval [CI] 0.23–2.05, p=0.505). MACE occurred in 151 patients (5.8%). MACE-free survival rates were comparable between groups (all: 94.4% vs. 93.9%, log rank p=0.234; PS-matched: 94.7% vs. 93.7%, log rank p=0.109). The use of ticagrelor vs. prasugrel was not predictive for improved MACE (all: hazard ratio [HR] 0.81, 95% CI 0.58–1.14, p=0.235; PS-matched: HR 0.39, 95% CI 0.12–1.29, p=0.123).
Conclusions: In ACS patients underwent PCI, the use of ticagrelor vs. prasugrel was equivalent in terms of bleeding rates and clinical outcomes.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Considerations in Antiplatelet Therapy and in ACS
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1113-135
- 2017 American College of Cardiology Foundation