Main results of two double-blind, randomized clinical trials that compared prasugrel and ticagrelor to clopidogrel for the treatment of patients with ACS
| Clinical trial . | Reference . | Patients . | Treatments . | Primary endpoints . | Follow-up . | Efficacy HR (95% CI) . | TIMI major bleedings* HR (95% CI) . |
|---|---|---|---|---|---|---|---|
| TRITON TIMI-38 | 82 | ACS with scheduled PCI | 1. Prasugrel + ASA | CV death, nonfatal stroke, nonfatal AMI | 6-15 mo | 0.81 | 1.32 |
| 2. Clopidogrel + ASA | (0.73-0.90) | (1.03-1.68) | |||||
| PLATO | 91 | ACS with or without ST elevation | 1. Ticagrelor + ASA | CV death,† AMI, stroke | 12 mo | 0.84 | 1.25 |
| 2. Clopidogrel + ASA | (0.77-0.92) | (1.03-1.53) |
| Clinical trial . | Reference . | Patients . | Treatments . | Primary endpoints . | Follow-up . | Efficacy HR (95% CI) . | TIMI major bleedings* HR (95% CI) . |
|---|---|---|---|---|---|---|---|
| TRITON TIMI-38 | 82 | ACS with scheduled PCI | 1. Prasugrel + ASA | CV death, nonfatal stroke, nonfatal AMI | 6-15 mo | 0.81 | 1.32 |
| 2. Clopidogrel + ASA | (0.73-0.90) | (1.03-1.68) | |||||
| PLATO | 91 | ACS with or without ST elevation | 1. Ticagrelor + ASA | CV death,† AMI, stroke | 12 mo | 0.84 | 1.25 |
| 2. Clopidogrel + ASA | (0.77-0.92) | (1.03-1.53) |
Although the investigators of the PLATO trial elaborated original criteria to classify the severity of bleeding episodes, they also calculated the incidence of bleedings based on TIMI criteria, which are reported in this table for easier comparison with the results of the TRITON TIMI-38 trial. Doses of the antiplatelet agents are as follows: prasugrel, 60 mg loading dose plus 10 mg daily; ticagrelor, 180 mg loading dose plus 90 mg twice a day; clopidogrel, 300 mg (TRITON TIMI-38) and 300 to 600 mg (PLATO) loading dose plus 75 mg daily; aspirin, 100 mg daily (TRITON TIMI-38) and 75 to 325 mg daily (PLATO).
HR indicates hazard ratio; CI, confidence interval; ACS, acute coronary syndrome; CV, cardiovascular; and AMI, acute myocardial infarction.
The non–CABG-related bleedings only are reported.
The incidence of death from any cause was significantly decreased by ticagrelor compared with clopidogrel.