TRITON-TIMI 38
Trial to Assess Improvement in Therapeutic Outcomes
Paziente / Popolazione Intervento / Esposizione Confronto Esito
In 13,608 ACS patients undergoing planned PCI, prasugrel reduced ischaemic events but increased major bleeding relative to clopidogrel.
N
13.608
Disegno
Double-blind RCT
Esito
CV death, non-fatal MI or non-fatal stroke
Rilevanza
2
Risultato9.9 % vs 12.1 % (HR 0.81). TIMI major bleed 2.4 % vs 1.8 %; fatal bleed higher with prasugrel.
Wiviott SD, et al. N Engl J Med. 2007;357(20):2001-2015. 10.1056/NEJMoa0706482
Discussione e critica
Net harm in patients > 75 y, < 60 kg, or with prior stroke/TIA — these subgroups are contraindications. Selection of P2Y12 inhibitor remains a balance of ischaemic vs bleeding risk.