Two Antiplatelets Equal in Head-to-Head Trial


The antiplatelet drugs prasugrel and ticagrelor are both fine for dual antiplatelet therapy following acute myocardial infarctions with ST segment elevations, a Czech study found.

Prasugrel (Effient/Daiichi-Sanyo) and ticagrelor (Brilinta/Astra-Zeneca) showed similar safety and efficacy in treating patients who needed dual antiplatelet therapy after a STEMI heart attack, a Czech study found.

Reporting at the European Society of Cardiology's ESC Congress 2016 in Rome, Italy, Petr Widimsky, MD, DrSc, of the Cardiocenter of Charles University in Prague, Czech Republic , said he and colleagues had tested the two drugs head to head in patients due to get primary percutaneous coronary intervention (PCI).

There were 1,230 patients in the study..

The primary endpoint was death, re-infarction, urgent target revascularization, stroke, serious bleeding requiring transfusion, or prolonged hospitalization at seven days.

Though the trial was halted prematurely when no difference in outcomes was seen, the team concluded that the rates of major cardiac events was so similar in the two groups (4% for prasugrel and 4.1% for ticagrelor) they found the findings adequate to establish the drugs performed equally well. The patients were tracked for one year.

"These results offer more freedom to clinicians to select the antiplatelet agent added on top of aspirin for patients with STEMI who receive dual antiplatelet therapy," he said.

As part of the ongoing research, they will also see what happens to patients in the group who, out of economic considerations, switch to clopidogrel, which is covered by the Czech government.

There were no data on these patients included in the study reported today.

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