Understanding and Treating Acute Coronary Syndrome - FreeCE
Understanding and Treating Acute Coronary Syndrome - FreeCE
Understanding and Treating Acute Coronary Syndrome - FreeCE
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Page 9<strong>Underst<strong>and</strong>ing</strong> <strong>and</strong> <strong>Treating</strong> <strong>Acute</strong> <strong>Coronary</strong> <strong>Syndrome</strong>© 2010 Pharmaceutical Education Consultants, Inc. unless otherwise noted. All rights reserved.Reproduction in whole or in part without permission is prohibited.Prasugrel versus Clopidogrel inPatients with <strong>Acute</strong> <strong>Coronary</strong><strong>Syndrome</strong>s (TRITON-TIMI 38)Wiviott SD, Braunwald E, et al.N Engl J Med 2007; 357: 2001-2015• Compare prasugrel with st<strong>and</strong>ard dose clopidogrel inpatients with ACS scheduled for PCI• Prospective, international, double-blind, r<strong>and</strong>omizedPrasugrel 60 mg load; 10 mg daily vsClopidogrel 300 mg load; 75 mg daily• 13,608 patients in 707 sites33• Inclusion Criteria• STEMI (n=3534)Study Population• Enrolled 12 hrs after onset of symptoms if primary PCI plannedor within 14 days after receiving treatment• Moderate to High Risk UA or NSTEMI (n=10,074)• Ischemic symptoms lasting ≥ 10 min <strong>and</strong> occurring within 72 hoursbefore r<strong>and</strong>omization• Exclusion Criteria• Increased risk of bleeding• Anemia• Thrombocytopenia• History of pathologic intracranial findings34Intervention• Choice of vessels treated, devices used <strong>and</strong>adjunctive medications was left to thediscretion of treating physicianEnd PointDeath from CV causes,nonfatal MI, or nonfatal strokeResultsPrasugrel(N=6813)Clopidogrel(N=6795)No. of patients (%)Hazard Ratiofor Prasugrel(95% CI)P Value643 (9.9) 781 (12.1) 0.81 (0.73-0.90)