Results of the PROMETHEUS study showed that prasugrel is more likely to be administered to lower-risk heart disease patients undergoing percutaneous coronary intervention (PCI) than clopidogrel. Study findings were presented at the Society for Cardiovascular Angiography and Interventions (SCAI) 2015 Scientific Sessions.
In the study, researchers evaluated data from 19,914 patients with heart disease undergoing PCI with stenting across eight medical centers between January 2010 and June 2013. They reviewed data on major adverse cardiac events (MACE), including death, heart attack, stroke, or unplanned revascularization, along with bleeding requiring hospitalization within 90 days of PCI for patients receiving either prasugrel or clopidogrel.
Patients that received prasugrel (n=4,058) tended to be younger, more often male, and had less renal dysfunction and anemia vs. patients that received clopidogrel (n=15,856). Study data showed that after 90 days, patients receiving prasugrel had lower rates of adverse events than those receiving clopidogrel (9.6% vs. 5.7%; P<0.001). After adjusting for baseline differences, the relative reduction was 11% favoring prasugrel. In addition, adjusted bleeding rate were not significantly different between the groups.
Researchers noted the differences in patient profiles receiving prasugrel vs. clopidogrel. In the prasugrel-treated patients, the risk factors for ischemic and hemorrhagic complications were much lower. Prasugrel is a P2Y12 platelet inhibitor approved bt the Food and Drug Administration (FDA) in 2009 to treat acute coronary syndrome (ACS) patients undergoing PCI.
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