Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38: An application of the classification system from the universal definition of myocardial infarction

David A. Morrow; Stephen D. Wiviott; Harvey D. White; Jose C. Nicolau; Ezio Bramucci; Sabina A. Murphy; Marc P. Bonaca; Christian T. Ruff; Benjamin M. Scirica; Carolyn H. McCabe; Elliott M. Antman; Eugene Braunwald

doi:10.1161/CIRCULATIONAHA.108.833665

Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38: An application of the classification system from the universal definition of myocardial infarction

David A. Morrow, Stephen D. Wiviott, Harvey D. White, Jose C. Nicolau, Ezio Bramucci, Sabina A. Murphy, Marc P. Bonaca, Christian T. Ruff, Benjamin M. Scirica, Carolyn H. McCabe, Elliott M. Antman, Eugene Braunwald

IRCCS Fondazione Policlinico San Matteo

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND-Prasugrel is a novel thienopyridine that reduces new or recurrent myocardial infarctions (MIs) compared with clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention. This effect must be balanced against an increased bleeding risk. We aimed to characterize the effect of prasugrel with respect to the type, size, and timing of MI using the universal classification of MI. METHODS AND RESULTS-We studied 13 608 patients with acute coronary syndrome undergoing percutaneous coronary intervention randomized to prasugrel or clopidogrel and treated for 6 to 15 months in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction (TRITON-TIMI 38). Each MI underwent supplemental classification as spontaneous, secondary, or sudden cardiac death (types 1, 2, and 3) or procedure related (Types 4 and 5) and examined events occurring early and after 30 days. Prasugrel significantly reduced the overall risk of MI (7.4% versus 9.7%; hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.67 to 0.85; P

Original language	English
Pages (from-to)	2758-2764
Number of pages	7
Journal	Circulation
Volume	119
Issue number	21
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.108.833665
Publication status	Published - Jun 2 2009

Keywords

Angioplasty
Myocardial infarction
Platelets
Prasugrel
Unstable angina

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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Morrow, D. A., Wiviott, S. D., White, H. D., Nicolau, J. C., Bramucci, E., Murphy, S. A., Bonaca, M. P., Ruff, C. T., Scirica, B. M., McCabe, C. H., Antman, E. M., & Braunwald, E. (2009). Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38: An application of the classification system from the universal definition of myocardial infarction. Circulation, 119(21), 2758-2764. https://doi.org/10.1161/CIRCULATIONAHA.108.833665

Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38 : An application of the classification system from the universal definition of myocardial infarction. / Morrow, David A.; Wiviott, Stephen D.; White, Harvey D.; Nicolau, Jose C.; Bramucci, Ezio; Murphy, Sabina A.; Bonaca, Marc P.; Ruff, Christian T.; Scirica, Benjamin M.; McCabe, Carolyn H.; Antman, Elliott M.; Braunwald, Eugene.

In: Circulation, Vol. 119, No. 21, 02.06.2009, p. 2758-2764.

Research output: Contribution to journal › Article › peer-review

Morrow, DA, Wiviott, SD, White, HD, Nicolau, JC, Bramucci, E, Murphy, SA, Bonaca, MP, Ruff, CT, Scirica, BM, McCabe, CH, Antman, EM & Braunwald, E 2009, 'Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38: An application of the classification system from the universal definition of myocardial infarction', Circulation, vol. 119, no. 21, pp. 2758-2764. https://doi.org/10.1161/CIRCULATIONAHA.108.833665

Morrow DA, Wiviott SD, White HD, Nicolau JC, Bramucci E, Murphy SA et al. Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38: An application of the classification system from the universal definition of myocardial infarction. Circulation. 2009 Jun 2;119(21):2758-2764. https://doi.org/10.1161/CIRCULATIONAHA.108.833665

Morrow, David A. ; Wiviott, Stephen D. ; White, Harvey D. ; Nicolau, Jose C. ; Bramucci, Ezio ; Murphy, Sabina A. ; Bonaca, Marc P. ; Ruff, Christian T. ; Scirica, Benjamin M. ; McCabe, Carolyn H. ; Antman, Elliott M. ; Braunwald, Eugene. / Effect of the novel thienopyridine prasugrel compared with clopidogrel on spontaneous and procedural myocardial infarction in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38 : An application of the classification system from the universal definition of myocardial infarction. In: Circulation. 2009 ; Vol. 119, No. 21. pp. 2758-2764.

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abstract = "BACKGROUND-Prasugrel is a novel thienopyridine that reduces new or recurrent myocardial infarctions (MIs) compared with clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention. This effect must be balanced against an increased bleeding risk. We aimed to characterize the effect of prasugrel with respect to the type, size, and timing of MI using the universal classification of MI. METHODS AND RESULTS-We studied 13 608 patients with acute coronary syndrome undergoing percutaneous coronary intervention randomized to prasugrel or clopidogrel and treated for 6 to 15 months in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction (TRITON-TIMI 38). Each MI underwent supplemental classification as spontaneous, secondary, or sudden cardiac death (types 1, 2, and 3) or procedure related (Types 4 and 5) and examined events occurring early and after 30 days. Prasugrel significantly reduced the overall risk of MI (7.4% versus 9.7%; hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.67 to 0.85; P",

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AU - Bonaca, Marc P.

AU - Ruff, Christian T.

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