Ticagrelor versus prasugrel in acute coronary syndrome: sex-specific analysis from the RENAMI Registry.

Abstract

BACKGROUND:

The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS population.

METHODS:

Data from the multicenter REgistry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) for 4424 ACS patients who underwent PCI and were treated with ticagrelor or prasugrel between 2012 to 2016 were analyzed. Mean follow-up was 17±9 months.

RESULTS:

After propensity score matching, there was no significant difference in the occurrence of primary endpoint of net adverse cardiac events between ticagrelor and prasugrel in men (HR: 0.94; 95% CI: 0.69-1.29; P=0.71), or women (HR: 1.17; 95% CI: 0.63-2.20; P=0.62; P interaction [sex] = 0.40). Similarly, no differences were found in the occurrence of any of the secondary endpoints (MACE, all cause death, re-infarction, stent thrombosis, BARC major bleeding and BARC any bleeding) between the two P2Y12 groups between men and women.

CONCLUSIONS:

In this real-world ACS population, no relative difference in efficacy or safety outcomes were found between ticagrelor and prasugrel between sexes.

• Authors: Sara Al Raisi, Majd Protty, Sergio Raposeiras-Roubín, Fabrizio D'Ascenzo, Emad Abu-Assi, Albert Ariza-Solé, Sergio Manzano-Fernández, Christian Templin, Lazar Velicki, Ioanna Xanthopoulou, Enrico Cerrato, Giorgio Quadri, Andrea Rognoni, Giacomo Boccuzzi, Andrea Montabone, Salma Taha, Alessandro Durante, Sebastiano Gili, Giulia Magnani, Michele Autelli, Alberto Grosso, Pedro Flores-Blanco, Ferdinando Varbella, María Cespón-Fernández, Diego Gallo, Umberto Morbiducci, Alberto Domínguez-Rodríguez, Ángel Cequier, Fiorenzo Gaita, Dimitrios Alexopoulos, Marco Valgimigli, Andrés Íñiguez-Romo, Tim Kinnaird
• Journal: Minerva cardiology and angiology (Minerva Cardiol Angiol) Vol. 69 Issue 4 Pg. 408-416 (Aug 2021) ISSN: 2724-5772 [Electronic] Italy
• PMID: 34137238 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Platelet Aggregation Inhibitors
• Prasugrel Hydrochloride
• Ticagrelor

Topics

• Acute Coronary Syndrome (drug therapy)
• Female
• Humans
• Male
• Percutaneous Coronary Intervention
• Platelet Aggregation Inhibitors (adverse effects)
• Prasugrel Hydrochloride (adverse effects)
• Registries
• Ticagrelor (adverse effects)
• Treatment Outcome