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Prasugrel versus clopidogrel for acute coronary syndromes without revascularization
- Source :
- The New England Journal of Medicine, 367, 14, pp. 1297-309, Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP, Roe, M T, Armstrong, P W, Fox, K A A, White, H D, Prabhakaran, D, Goodman, S G, Cornel, J H, Bhatt, D L, Clemmensen, P, Martinez, F, Ardissino, D, Nicolau, J C, Boden, W E, Gurbel, P A, Ruzyllo, W, Dalby, A J, McGuire, D K, Leiva-Pons, J L, Parkhomenko, A, Gottlieb, S, Topacio, G O, Hamm, C, Pavlides, G, Goudev, A R, Oto, A, Tseng, C-D, Merkely, B, Gasparovic, V, Corbalan, R, Cinteză, M, McLendon, R C, Winters, K J, Brown, E B, Lokhnygina, Y, Aylward, P E, Huber, K & Hochman, J S & Ohman, E M 2012, ' Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization ', New England Journal of Medicine, vol. 367, no. 14, pp. 1297-1309 . https://doi.org/10.1056/NEJMoa1205512, The New England Journal of Medicine, 367, 1297-309
- Publication Year :
- 2012
- Publisher :
- Massachussetts Medical Society, 2012.
-
Abstract
- Item does not contain fulltext BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel. RESULTS: At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval [CI], 0.79 to 1.05; P=0.21). Similar results were observed in the overall population. The prespecified analysis of multiple recurrent ischemic events (all components of the primary end point) suggested a lower risk for prasugrel among patients under the age of 75 years (hazard ratio, 0.85; 95% CI, 0.72 to 1.00; P=0.04). Rates of severe and intracranial bleeding were similar in the two groups in all age groups. There was no significant between-group difference in the frequency of nonhemorrhagic serious adverse events, except for a higher frequency of heart failure in the clopidogrel group. CONCLUSIONS: Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).
- Subjects :
- Male
Prasugrel
Myocardial Infarction
Kaplan-Meier Estimate
Piperazines
Purinergic P2 Receptor Antagonists
Myocardial infarction
education.field_of_study
Cardiovascular diseases [NCEBP 14]
Acute Coronary Syndrome
Aged
Angina, Unstable
Aspirin
Cardiovascular Diseases
Double-Blind Method
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Middle Aged
Platelet Aggregation Inhibitors
Prasugrel Hydrochloride
Stroke
Thiophenes
Ticlopidine
Medicine (all)
Hazard ratio
Clopidogrel
Acute Coronary Syndromes
General Medicine
Angina
Combination
Cardiology
medicine.drug
medicine.medical_specialty
Acute coronary syndrome
Population
Unstable
Drug Therapy
General & Internal Medicine
Internal medicine
medicine
cardiovascular diseases
education
Acute coronary syndromes
Revascularisation
Unstable angina
business.industry
medicine.disease
REVASCULARIZAÇÃO MIOCÁRDICA
business
Subjects
Details
- Language :
- English
- ISSN :
- 00284793
- Database :
- OpenAIRE
- Journal :
- The New England Journal of Medicine, 367, 14, pp. 1297-309, Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP, Roe, M T, Armstrong, P W, Fox, K A A, White, H D, Prabhakaran, D, Goodman, S G, Cornel, J H, Bhatt, D L, Clemmensen, P, Martinez, F, Ardissino, D, Nicolau, J C, Boden, W E, Gurbel, P A, Ruzyllo, W, Dalby, A J, McGuire, D K, Leiva-Pons, J L, Parkhomenko, A, Gottlieb, S, Topacio, G O, Hamm, C, Pavlides, G, Goudev, A R, Oto, A, Tseng, C-D, Merkely, B, Gasparovic, V, Corbalan, R, Cinteză, M, McLendon, R C, Winters, K J, Brown, E B, Lokhnygina, Y, Aylward, P E, Huber, K & Hochman, J S & Ohman, E M 2012, ' Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization ', New England Journal of Medicine, vol. 367, no. 14, pp. 1297-1309 . https://doi.org/10.1056/NEJMoa1205512, The New England Journal of Medicine, 367, 1297-309
- Accession number :
- edsair.doi.dedup.....15d2cee31ff3cef4df1a84a24b92331d