Trial | Study population | Study groups | Outcome/adverse event | Intervention; % of patients | p value | |
---|---|---|---|---|---|---|
Prasugrel | Clopidogrel | |||||
TRITON– TIMI 38 21 | 13 608 patients with acute coronary syndromes scheduled to have PCI |
| Cardiac death, MI or stroke (primary outcome) | 9.9 | 12.1 | < 0.0012 |
Death, any cause | 3.0 | 3.2 | 0.64 | |||
Major bleeding | 2.4 | 1.8 | 0.03 | |||
Life-threatening bleeding | 1.4 | 0.9 | 0.01 | |||
TRILOGY ACS 22 | 7 243 patients with unstable angina or acute coronary syndromes without ST-segment elevation without scheduled revascularization |
| Cardiac death, MI or stroke (primary outcome) | 18.7 | 20.3 | 0.45 |
Major bleeding | 2.5 | 1.8 | 0.29 | |||
Ticagrelor | Clopidogrel | |||||
PLATO 23 | 18 624 patients with acute coronary syndromes |
| Death, MI or stroke (primary outcome) | 9.8 | 11.7 | < 0.001 |
Death, any cause | 4.0 | 5.1 | 0.001 | |||
Stent thrombosis | 2.9 | 3.8 | 0.01 | |||
Major bleeding | 11.6 | 11.2 | 0.43 | |||
Bleeding unrelated to CABG | 4.5 | 3.8 | 0.03 | |||
Dyspnea | 13.8 | 7.8 | < 0.001 | |||
Ventricular pauses > 3 s | 5.8 | 3.6 | 0.01 | |||
High-dose ASA | Low-dose ASA | |||||
CURRENT– OASIS 7 13 | 25 086 patients with acute coronary syndromes scheduled to have PCI |
| Cardiac death, MI or stroke (primary outcome) | 4.2 | 4.4 | 0.61 |
Major bleeding | 2.3 | 2.3 | 0.90 | |||
| Double-dose clopidogrel | Standard-dose clopidogrel | ||||
Cardiac death, MI or stroke (primary outcome) | 4.2 | 4.4 | 0.30 | |||
Major bleeding | 2.5 | 2.0 | 0.01 |
Note: ASA = acetylsalicylic acid, CABG = coronary artery bypass graft surgery, CURRENT–OASIS 7 = Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events–Seventh Organization to Assess Strategies in Ischemic Syndromes, MI = myocardial infarction, PCI = percutaneous coronary intervention, PLATO = Study of Platelet Inhibition and Patient Outcomes, TRILOGY ACS = Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes, TRITON–TIMI = Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel–Thrombolysis in Myocardial Infarction.