Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients With Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization
Primary resultResult — go to the resultHazard ratio 1.007 95% CI 0.78–1.30Authors' conclusion
The present study in elderly patients with acute coronary syndromes showed no difference in the primary end point between reduced-dose prasugrel and standard-dose clopidogrel.
Study context
- Population
- Patients >74 years with ACS undergoing PCI40% women
- Participants
- 1,443 patients
- Comparison
- Prasugrel 5 mg vs clopidogrel 75 mg
- Primary endpoint
- Composite of:
- Mortality
- MI
- Disabling stroke
- Rehospitalization for CV causes or bleeding
- Follow-up
- 1 year
Methodological detailsmulticentre, open-label, blinded end point, superiority, planned interim analysis, Enrollment interrupted, per prespecified criteria, after a planned interim analysis because of futility for efficacy
- Multicentre
- Open-label
- Blinded end point
- Superiority
- Planned interim analysis
- Enrollment interrupted, per prespecified criteria, after a planned interim analysis because of futility for efficacy
Primary result
As reported in the abstract
Hazard ratio
1.007
95% CI 0.78–1.30
P = 0.955
Events by treatment group
Prasugrelvs Clopidogrel
HR 1.007 (95% CI 0.78–1.30); P = 0.955
Further findings
| Outcome | Prasugrel | Clopidogrel | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Definite/probable stent thrombosis | 0.7% | 1.9% | 0.36 (0.13–1.00) | P = 0.06 | |
| 0.10.31310Odds ratio (log scale) |
Safety
| Outcome | Prasugrel | Clopidogrel | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| BARC type ≥2 bleeding | 4.1% | 2.7% | 1.52 (0.85–3.16) | P = 0.18 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients With Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization. Circulation. Published 19 February 2018. doi:10.
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