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SCAI-ACC: Prasugrel Beneficial for Coronary Syndromes

Prasugrel reduces stent thrombosis better than clopidogrel

MONDAY, March 31 (HealthDay News) -- Intensive antiplatelet treatment with prasugrel is superior to clopidogrel in improving outcomes and reducing stent thrombosis in patients with acute coronary syndromes who have coronary stents, according to the results of a study published online March 31 in The Lancet and presented at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit in Chicago this week.

Stephen D. Wiviott, M.D., from Brigham and Women's Hospital in Boston, and colleagues randomly assigned 12,844 patients with moderate- to high-risk acute coronary syndromes and at least one coronary stent (45 percent drug-eluting stents only, 55 percent bare-metal stents only) to prasugrel or clopidogrel for six to 15 months. All patients also received aspirin.

The researchers found that cardiovascular death, non-fatal myocardial infarction or non-fatal stroke was significantly reduced in the prasugrel group (9.7 versus 11.9 percent, hazard ratio 0.81), regardless of stent type. Stent thrombosis was also significantly reduced in the prasugrel group (1.13 versus 2.35 percent, hazard ratio 0.48), also regardless of stent type.

"Intensive antiplatelet therapy with prasugrel resulted in fewer ischemic outcomes including stent thrombosis than with standard clopidogrel," Wiviott and colleagues conclude.

The study was supported by research grants from Daiichi Sankyo and Eli Lilly.

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