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We lack enough comparative effectiveness studies in cardiology, and so an investigator-initiated, non–industry-funded, randomized study comparing ticagrelor and prasugrel strategies in patients with an acute coronary syndrome (ACS) is welcome (NCT01944800).
The 4018 patients were hospitalized with an ACS and scheduled for a coronary angiography study. At randomization, ticagrelor was started with a loading dose of 180 mg; the maintenance dose was 90 mg twice daily. Prasugrel was started with a loading dose of 60 mg and continued at 10 mg per day (5 mg per day for those aged ≥75 or weighing <60 kg). In the prasugrel arm, patients with ST-segment elevation myocardial infarction (STEMI) received the drug at randomization; patients with other AC…