The TAXUS Liberté Post Approval study included patients treated with TAXUS paclitaxel DES receiving prasugrel for 12 to 30 months. Primary end point was a combination of death, infarction or stroke that resulted in 3.7% after 30 months vs. 8.8% after 12 months of prasugrel administration (p<0.001).
Death and stroke rates were similar between the two groups but the infarction rate saw a significant reduction after prolonged double antiaggregation therapy with aspirin and prasugrel (1.9% vs 7.1%; p<0,001).
In stent thrombosis was also lower after prolonged therapy (0.2% vs 2.9%; p<0,001). Infarction rate was higher within 90 days after prasugrel withdrawal in both groups.
Safety end point (a combination of moderate and severe bleeding) was slightly higher in the 30 month group (2.4% vs 1.7%; p= 0,234) but looking at severe bleeding alone, rates saw no significant difference (0.3% vs 0.5%; p=0,471).
Conclusion
The combined administration of prasugrel and aspirin at 30 months reduced ischemic events rates in patients receiving TAXUS mainly due to reduced rates of infarction and in stent thrombosis, compared to the 12 month treatment.
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Kirk N Garratt
2014-11-17
Original title: Increased Risk of Ischemic Events Upon Discontinuation of Prasugrel After 12 or 30 Months of Therapy Following Placement of the Taxus Liberté Paclitaxel- Eluting Coronary Stent.