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The efficacy and safety of prasugrel with and without a glycoprotein IIb/IIIa inhibitor in patients with acute coronary syndromes undergoing percutaneous intervention: A TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis In Myocardial Infarction 38) analysis
JACC - Journal of the American College of Cardiology, 08/13/09
O'Donoghue M et al. – Prasugrel significantly reduces the risk of cardiovascular events in pts with acute coronary syndromes after percutaneous coronary intervention, regardless of glycoprotein (GP) IIb/IIIa inhibitor use.
Methods- Study of efficacy and safety of prasugrel and clopidogrel in setting of glycoprotein (GP) IIb/IIIa inhibitor use
- TRITON–TIMI 38: randomization of 13,608 subjects with acute coronary syndrome undergoing percutaneous coronary intervention to prasugrel vs clopidogrel
- GP IIb/IIIa inhibitor use at physician's discretion
- Endpoints examined at 30 days and stratified by GP IIb/IIIa inhibitor use
- GP IIb/IIIa inhibitor during index hospitalization for 7,414 subjects (54.5%)
- Consistent benefit of prasugrel vs clopidogrel for reducing cardiovascular death, myocardial infarction, or stroke in pts treated/not treated with GP IIb/IIIa inhibitor
- Prasugrel significantly reduced myocardial infarction, urgent revascularization, and stent thrombosis irrespective of GP IIb/IIIa inhibitor use
- Bleeding rates greater with GP IIb/IIIa inhibitor use
- For prasugrel vs clopidogrel, no significant difference in pts treated/not treated with GP IIb/IIIa inhibitor for risk of thrombolysis in myocardial infarction major or minor bleeding
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