Prasugrel Pretreatment Before PCI in NSTEMI Patients Is Not Beneficial

This approach was associated with higher bleeding events but no differences in other major outcomes.

Despite the theoretical appeal, using potent antiplatelet agents before beginning an early invasive strategy in patients with non–ST-segment elevation myocardial infarction (NSTEMI) has generally not been beneficial. Now, investigators have reanalyzed data from the large, randomized, double-blind, industry-supported ACCOAST trial, to examine the effect of such pretreatment in the subset of 2770 NSTEMI patients who underwent percutaneous coronary intervention (PCI) as part of an early invasive strategy.

Patients received either 30 mg of prasugrel or placebo after the diagnosis of NSTEMI and before diagnostic angiography; at PCI, the pretreatment group received an additional 30 mg, and the control group received 60 mg of prasugrel. The median …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)