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Pre-admission antiplatelet therapy and treatment effect of ticagrelor vs. prasugrel in patients with acute coronary syndromes: a subgroup analysis of the ISAR-REACT 5 trial : original article : acute coronary syndromes

To assess whether the efficacy and safety of ticagrelor vs. prasugrel in patients with acute coronary syndromes (ACSs) are influenced by pre-admission treatment with aspirin and/or clopidogrel.Patients (n = 4018) were categorized into two groups: pre-admission aspirin and/or clopidogrel group (n = 1...

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Main Authors: Lahu, Shqipdona (Author) , Ndrepepa, Gjin (Author) , Neumann, Franz-Josef (Author) , Menichelli, Maurizio (Author) , Bernlochner, Isabell (Author) , Richardt, Gert (Author) , Wöhrle, Jochen (Author) , Witzenbichler, Bernhard (Author) , Hemetsberger, Rayyan (Author) , Mayer, Katharina (Author) , Akın, Ibrahim (Author) , Cassese, Salvatore (Author) , Gewalt, Senta (Author) , Xhepa, Erion (Author) , Kufner, Sebastian (Author) , Valina, Christian (Author) , Sager, Hendrik B (Author) , Joner, Michael (Author) , Ibrahim, Tareq (Author) , Laugwitz, Karl-Ludwig (Author) , Schunkert, Heribert (Author) , Schüpke, Stefanie (Author) , Kastrati, Adnan (Author)
Format: Article (Journal)
Language:English
Published: 22 February 2022
In: European heart journal - cardiovascular pharmacotherapy
Year: 2022, Volume: 8, Issue: 7, Pages: 687-694
ISSN:2055-6845
DOI:10.1093/ehjcvp/pvac007
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/ehjcvp/pvac007
Verlag, lizenzpflichtig, Volltext: https://academic.oup.com/ehjcvp/article/8/7/687/6534407?login=true
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Author Notes:Shqipdona Lahu, Gjin Ndrepepa, Franz-Josef Neumann, Maurizio Menichelli, Isabell Bernlochner, Gert Richardt, Jochen Wöhrle, Bernhard Witzenbichler, Rayyan Hemetsberger, Katharina Mayer, Ibrahim Akin, Salvatore Cassese, Senta Gewalt, Erion Xhepa, Sebastian Kufner, Christian Valina, Hendrik B. Sager, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Heribert Schunkert, Stefanie Schüpke and Adnan Kastrati
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Summary:To assess whether the efficacy and safety of ticagrelor vs. prasugrel in patients with acute coronary syndromes (ACSs) are influenced by pre-admission treatment with aspirin and/or clopidogrel.Patients (n = 4018) were categorized into two groups: pre-admission aspirin and/or clopidogrel group (n = 1455) and no pre-admission aspirin or clopidogrel group (n = 2563). The primary endpoint was the composite of all-cause death, myocardial infarction, or stroke; the secondary safety endpoint was Bleeding Academic Research Consortium (BARC) type 3-5 bleeding, both at 1 year. Patients in the pre-admission aspirin and/or clopidogrel group had a higher risk of ischaemic events, but a similar risk of bleeding to patients in the no pre-admission aspirin or clopidogrel group (cumulative incidences 10.5% vs. 6.7%, and 5.7% vs. 5.7%, respectively). The primary endpoint occurred in 81/717 patients assigned to ticagrelor and 69/738 patients assigned to prasugrel in the pre-admission aspirin and/or clopidogrel group [11.5% vs. 9.5%; hazard ratio (HR) = 1.23; 95% confidence interval (CI) 0.89-1.69], and in 103/1295 patients assigned to ticagrelor and 68/1268 patients assigned to prasugrel in the no pre-admission aspirin or clopidogrel group [8.0% vs. 5.4%; HR = 1.50 (1.10-2.03); Pint = 0.38]. BARC type 3-5 bleeding events did not differ between ticagrelor and prasugrel in patients in the pre-admission aspirin and/or clopidogrel (6.2% vs. 4.5%) or no pre-admission aspirin or clopidogrel (5.3% vs. 5.1%) group (Pint = 0.54).In patients with ACS, pre-admission therapy with aspirin and/or clopidogrel has no influence on the relative efficacy and safety of ticagrelor and prasugrel.
Item Description:Gesehen am 26.09.2023
Physical Description:Online Resource
ISSN:2055-6845
DOI:10.1093/ehjcvp/pvac007

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