Single Study Offers Insights on Ticagrelor vs Prasugrel Chronic Cardiovascular Disease
Samin Sharma, MD, discusses a study finding that patients with chronic or acute coronary syndromes undergoing percutaneous coronary intervention have comparable safety and efficacy outcomes at one year whether or not they were initially discharged on aspirin plus prasugrel or aspirin plus ticagrelor. He said, “First, they weren’t able to capture exactly how long patients stayed on DAPT, especially past 1 year, and this duration may have had an impact on outcomes.” Also, he said, there was likely some degree of crossover they couldn’t account for—likely between 5 percent and 8 percent—but more likely from one of the more potent agents to clopidogrel as opposed to from one to another. “With antiplatelet therapies constantly evolving, I hope this paper will add comfort to a lot of people who are always concerned about two things. First, I stressed, prasugrel and ticagrelor are safe in both ACS and stable CAD. Second, using a prasugrel dose of 5 mg is good enough for many patients and may cause less bleeding compared with the standard 10-mg dose.
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