Ticagrelor versus prasugrel in acute coronary syndrome: sex-specific analysis from the RENAMI Registry

Abstract

Background: The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS population. Methods: Data from the multicentre REgistry of New Antiplatelets in patients withMyocardial Infarction for 4424 ACS patients who underwent PCI and were treated with ticagrelor or prasugrel between 2012 to 2016 were analysed. Mean follow-up was 17 ± 9 months. Results: After propensity score matching, there was no significant difference in the occurrence of primary endpoint of net adverse cardiac events between the ticagrelor and prasugrel in men (HR: 0.94; 95% CI: 0.69-1.29; p=0.71), or women (HR: 1.17; 95% CI: 0.63-2.20; p=0.62; p interaction [sex] = 0.40). Similarly, no differences were found in the occurrence of any of the secondary endpoints (MACE, all cause death, re-infarction, stent thrombosis, BARC major bleeding and BARC any bleeding) between the two P2Y12 groups between men and women. Conclusion:In this real-world ACS population, no relative difference in efficacy or safety outcomes were found between ticagrelor and prasugrel between sexes.

Dual Antiplatelet Therapy After Drug-Eluting Stents Implantation in East Asians: A Network Meta-Analysis of Randomized Controlled Trials

“…32,33 In addition, in patients with ACS undergoing percutaneous coronary interventions, the use of potent P2Y12 inhibitors (ticagrelor or prasugrel) is a class I recommendation. 34 Shortening the duration of DAPT and switching from ticagrelor or prasugrel to clopidogrel may increase the risk of ischemia in patients with ACS. According to the results of subgroup analysis and the past studies, the short-term DAPT followed by a P2Y12 inhibitors monotherapy may be a good choice for patients with ACS.…”

Pharmacological Approaches to Limit Ischemic and Reperfusion Injuries of the Heart: Analysis of Experimental and Clinical Data on P2Y12 Receptor Antagonists

“… 39) In the multicenter Registry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) trial enrolled 4,424 ACS patients with PCI it was demonstrated that efficacy or safety of ticagrelor and prasugrel is identical. 78) …”