TRANSLATE-ACS: One-year prasugrel versus clopidogrel after acute coronary syndrome

Platelet inhibition is critical in reducing atherothrombotic risk in the short and long term after an acute coronary syndrome, especially if the patient has received coronary angioplasty. Few data are available in the real world in terms of safety and efficacy of prasugrel versus clopidogrel in this clinical context. This registry involved 12227 patients undergoing acute coronary syndrome treated with coronary angioplasty, and who were receiving clopidogrel or prasugrel. 

Patients receiving prasugrel show more frequently ST-segment elevation, were younger and male.  The combined end point (death, myocardial infarction, stroke, urgent revascularization) was minor in the prasugrel group (13.1% versus 17.1%, P <0.0001). However after adjusting the two populations for all the differences not significant variances, (p = 059) were observed. In the adjusted analysis, the prasugrel group had fewer stent thrombosis (p = 0.02) and more bleeding (p = 0.02) than clopidogrel. 

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Tracy Y. Wang
2014-09-16

Original title: A Large-Scale Registry Comparing Patterns of Use and One-Year Outcomes with Prasugrel Versus Clopidogrel in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

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