ISAR-REACT 5
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
Paciente / Población Intervención / Exposición Comparación Desenlace
In 4,018 patients with acute coronary syndromes managed invasively, prasugrel reduced death, MI or stroke at one year compared with ticagrelor.
N
4018
Diseño
Investigator-initiated, open-label RCT
Desenlace
Death, MI or stroke at 12 months
Relevancia
2
Resultado9.3 % (ticagrelor) vs 6.9 % (prasugrel) — HR 1.36 favouring prasugrel; major bleeding similar.
Schüpke S, et al. N Engl J Med. 2019;381(16):1524-1534. 10.1056/NEJMoa1908973
Discusión y crítica
Open-label design and higher ticagrelor discontinuation drew criticism. Nonetheless shifted ESC preference towards prasugrel in NSTE-ACS without pre-treatment.