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Posted by on Apr 16, 2016 in Coronary artery disease | 0 comments

In a nutshell

This paper compared prasugrel and clopidogrel in the treatment of patients with acute coronary syndrome. Results suggested that prasugrel could be potentially beneficial over the long term in patients with acute coronary syndrome.

Some background

Acute coronary syndrome refers to situations where blood supplying the heart is blocked. This includes heart attack and angina (chest pain). Prasugrel and clopidogrel are therapies that stop platelets (red blood cells) from sticking together (clotting). Compared to clopidogrel, prasugrel has been shown to be more potent and have less varied outcomes. The authors compared prasugrel and clopidogrel in patients without a previous stroke.

Methods & findings

7243 patients were analyzed. Patients were randomly assigned to receive prasugrel or clopidogrel. All patients received aspirin as well.

The rate of strokes was 1.1% over an average follow-up period of 17 months. Patients who had a stroke were more likely to be older, and have other illnesses.

Frequency of strokes overall was less common among patients receiving prasugrel than patients receiving clopidogrel but this difference was not significant. There was no difference between prasugrel and clopidogrel in the risk of ischemic stroke after 3 months of treatment. However, after 12 months, patients who received prasugrel had a significantly reduced risk of ischemic stroke compared to patients who received clopidogrel

The bottom line

The authors concluded that a longer duration of more intense platelet inhibition with prasugrel could be associated with lower rates of stroke in patients with acute coronary syndrome. 

The fine print

The rate of stroke was low, so the evidence for the results are not strong. 

What’s next?

Talk to your doctor about treatment options to reduce your risk of stroke. 

Published By :

Stroke

Date :

Feb 16, 2016

Original Title :
Time-Varying Effects of Prasugrel Versus Clopidogrel on the Long-Term Risks of Stroke after Acute Coronary Syndromes: Results from the TRILOGY ACS Trial.
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