Prasugrel vs. Clopidogrel in Patients with ST-Segment-Elevation MI

A substudy of TRITON-TIMI 38 confirms the main trial findings that prasugrel is more efficacious but might be less safe than clopidogrel.

The results of the manufacturer-sponsored TRITON-TIMI 38 suggested that prasugrel, a new thienopyridine awaiting FDA approval, is superior to clopidogrel at reducing rates of ischemic events after percutaneous coronary intervention in patients with acute coronary syndromes — but at a cost of increased bleeding events (JW Cardiol Nov 4 2007).

The present report contains findings from a prespecified subanalysis in patients with ST-segment-elevation MI. The investigators had randomized 3534 STEMI patients to receive prasugrel (loading dose, 60 mg; maintenance dose, 10 mg) or clopidogrel (loading dose, 300 mg; maintenance dose, 75 mg) for a median of 15 months. Ninety-two percent of participants received at least one coronary stent (59% bare-met…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)