Abstract
Background Acute coronary syndrome (ACS) mortality increases when the culprit lesion is in the left anterior descending (LAD) artery. We investigated the effects of prasugrel versus clopidogrel according to site of culprit lesion causing ACS treated with percutaneous coronary intervention (PCI) in the TRITON–TIMI 38 study. Methods Patients were divided into three groups based on the native coronary artery culprit lesion location. The LAD artery group included also patients with the culprit lesion in the left main (LM) artery. Results In the whole ACS population, prasugrel recipients had lower rates of the primary endpoint that included cardiovascular (CV) death, non-fatal myocardial infarction (MI) or non-fatal stroke without significant differences across vessel groups. CV death was significantly decreased with prasugrel in the whole ACS population (p = 0.03) and in ST-elevation MI (STEMI) patients undergoing primary PCI (p = 0.04), with pronounced differences in favour of prasugrel versus clopidogrel when the LAD-LM was the culprit vessel (relative risk reduction 50% in the whole ACS population, 57% in STEMI treated with primary PCI, p for interaction 0.07 and 0.08 respectively). Conclusions Prasugrel effects were particularly favourable when LAD-LM was the culprit vessel, resulting in CV mortality reduction in the whole ACS population and in STEMI patients when treated with primary PCI.
| Original language | English |
|---|---|
| Pages (from-to) | 632-638 |
| Number of pages | 7 |
| Journal | International Journal of Cardiology |
| Volume | 223 |
| DOIs | |
| Publication status | Published - Nov 15 2016 |
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Keywords
- Acute coronary syndromes
- P2Y12 inhibitors
- Prasugrel
ASJC Scopus subject areas
- Medicine(all)
- Cardiology and Cardiovascular Medicine
Cite this
Prasugrel versus clopidogrel in acute coronary syndromes treated with PCI : Effects on clinical outcome according to culprit artery location. / De Servi, Stefano; Goedicke, Jochen; Ferlini, Marco; Palmerini, Tullio; Syvänne, Mikko; Montalescot, Gilles.
In: International Journal of Cardiology, Vol. 223, 15.11.2016, p. 632-638.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prasugrel versus clopidogrel in acute coronary syndromes treated with PCI
T2 - Effects on clinical outcome according to culprit artery location
AU - De Servi, Stefano
AU - Goedicke, Jochen
AU - Ferlini, Marco
AU - Palmerini, Tullio
AU - Syvänne, Mikko
AU - Montalescot, Gilles
PY - 2016/11/15
Y1 - 2016/11/15
N2 - Background Acute coronary syndrome (ACS) mortality increases when the culprit lesion is in the left anterior descending (LAD) artery. We investigated the effects of prasugrel versus clopidogrel according to site of culprit lesion causing ACS treated with percutaneous coronary intervention (PCI) in the TRITON–TIMI 38 study. Methods Patients were divided into three groups based on the native coronary artery culprit lesion location. The LAD artery group included also patients with the culprit lesion in the left main (LM) artery. Results In the whole ACS population, prasugrel recipients had lower rates of the primary endpoint that included cardiovascular (CV) death, non-fatal myocardial infarction (MI) or non-fatal stroke without significant differences across vessel groups. CV death was significantly decreased with prasugrel in the whole ACS population (p = 0.03) and in ST-elevation MI (STEMI) patients undergoing primary PCI (p = 0.04), with pronounced differences in favour of prasugrel versus clopidogrel when the LAD-LM was the culprit vessel (relative risk reduction 50% in the whole ACS population, 57% in STEMI treated with primary PCI, p for interaction 0.07 and 0.08 respectively). Conclusions Prasugrel effects were particularly favourable when LAD-LM was the culprit vessel, resulting in CV mortality reduction in the whole ACS population and in STEMI patients when treated with primary PCI.
AB - Background Acute coronary syndrome (ACS) mortality increases when the culprit lesion is in the left anterior descending (LAD) artery. We investigated the effects of prasugrel versus clopidogrel according to site of culprit lesion causing ACS treated with percutaneous coronary intervention (PCI) in the TRITON–TIMI 38 study. Methods Patients were divided into three groups based on the native coronary artery culprit lesion location. The LAD artery group included also patients with the culprit lesion in the left main (LM) artery. Results In the whole ACS population, prasugrel recipients had lower rates of the primary endpoint that included cardiovascular (CV) death, non-fatal myocardial infarction (MI) or non-fatal stroke without significant differences across vessel groups. CV death was significantly decreased with prasugrel in the whole ACS population (p = 0.03) and in ST-elevation MI (STEMI) patients undergoing primary PCI (p = 0.04), with pronounced differences in favour of prasugrel versus clopidogrel when the LAD-LM was the culprit vessel (relative risk reduction 50% in the whole ACS population, 57% in STEMI treated with primary PCI, p for interaction 0.07 and 0.08 respectively). Conclusions Prasugrel effects were particularly favourable when LAD-LM was the culprit vessel, resulting in CV mortality reduction in the whole ACS population and in STEMI patients when treated with primary PCI.
KW - Acute coronary syndromes
KW - P2Y12 inhibitors
KW - Prasugrel
UR - http://www.scopus.com/inward/record.url?scp=84983317425&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84983317425&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2016.08.242
DO - 10.1016/j.ijcard.2016.08.242
M3 - Article
VL - 223
SP - 632
EP - 638
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -