Coronary disease & ACSRandomised controlled trial
Prasugrel versus Ticagrelor in Acute Coronary Syndromes
- Randomised controlled trial
- registry-based
- open-label
- stepped-wedge
- cluster-randomized
Authors' conclusion
In an unselected population of patients with an acute coronary syndrome who had undergone percutaneous coronary intervention, the risk of ischemic events was not lower with a default prasugrel policy than with a default ticagrelor policy.
Study context
- Population
- Adults who had undergone PCI for ACS in Sweden (7 regions, 3 clusters, 2021–2024)
- Participants
- 17,095 adults
- Comparison
- Default prasugrel policy vs default ticagrelor policy
- Prasugrel policyn = 7,651
- Ticagrelor policyn = 9,444reference
- Primary endpoint
- Composite of:
- All-cause death
- Fatal or nonfatal MI
- Fatal or nonfatal stroke
- Follow-up
- 1 year
Primary result
As reported in the abstract
Adjusted odds ratio
0.90
95% CI 0.77–1.06
By group
Prasugrel policy vs Ticagrelor policy
adjusted OR 0.90 (95% CI 0.77–1.06)
Safety
| Outcome | Ticagrelor policy | Prasugrel policy | adjusted OR (95% CI) | |
|---|---|---|---|---|
| Major bleeding · 1 year | 4.4% | 4.2% | 0.80 (0.64–0.99) | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Prasugrel versus Ticagrelor in Acute Coronary Syndromes. N Engl J Med. Published 29 August 2026. doi:10.1056/nejmoa2609057
Summarised from the published abstract; every number is checked against it