ISAR-REACT 5
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
Paziente / Popolazione Intervento / Esposizione Confronto Esito
In 4,018 patients with acute coronary syndromes managed invasively, prasugrel reduced death, MI or stroke at one year compared with ticagrelor.
N
4018
Disegno
Investigator-initiated, open-label RCT
Esito
Death, MI or stroke at 12 months
Rilevanza
2
Risultato9.3 % (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
Discussione e critica
Open-label design and higher ticagrelor discontinuation drew criticism. Nonetheless shifted ESC preference towards prasugrel in NSTE-ACS without pre-treatment.