Impact of shifting from routine use of ticagrelor to prasugrel in myocardial infarction patients after percutaneous coronary intervention (PCI): a nationwide cohort study
Main finding · MACEResult — go to the resultAdjusted hazard ratio 0.67 95% CI 0.47–0.95Authors' conclusion
Prasugrel was associated with reduced rates of MACE and MI and with similar bleeding rates compared with ticagrelor, supporting current guideline recommendations.
Study context
- Population
- Myocardial infarction (MI) patients treated with PCI 2019–2022 without contraindications, alive and redeeming prasugrel or ticagrelor within 7 days of discharge, Danish nationwide registries
- Participants
- 10,984 patients
- Exposure
- Prasugrel vs ticagrelor after PCI for MI
- Outcome
- Major adverse cardiovascular events (MACE)
- Follow-up
- 1 year
Methodological detailsregister-based, nationwide
- Register-based
- Nationwide
Main finding
As reported in the abstract
Adjusted hazard ratio
0.67
95% CI 0.47–0.95
Prasugrelvs Ticagrelor
adjusted HR 0.67 (95% CI 0.47–0.95)
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| MI · 1 year | 0.65 (0.44–0.96) | |
| 0.512Adjusted hazard ratio (log scale) |
Switching from P2Y12 inhibitor
Uptake of prasugrel over time
- Patients treated with ticagrelor in 2019
- >99%
- Patients treated with prasugrel by 2022
- 89%
- Overall share redeeming prasugrel
- 38.0%
- Overall share redeeming ticagrelor
- 62.0%
Sensitivity and subgroup analyses (propensity score-matched, age ≥75 years, NSTEMI)
- Findings replicated in propensity score-matched population, patients aged ≥75 years and NSTEMI patients
Safety
- No differences in bleeding after adjustment
Original publication
Impact of shifting from routine use of ticagrelor to prasugrel in myocardial infarction patients after PCI: a nationwide cohort study. EuroIntervention. Published 3 November 2025. doi:10.
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