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dc.contributor.authorMurphy, Sabina A.
dc.contributor.authorAntman, Elliott Marshall
dc.contributor.authorWiviott, Stephen Daniel
dc.contributor.authorWeerakkody, Govinda
dc.contributor.authorMorocutti, Giorgio
dc.contributor.authorHuber, Kurt
dc.contributor.authorLopez-Sendon, Jose
dc.contributor.authorMcCabe, Carolyn Hoss
dc.contributor.authorBraunwald, Eugene
dc.date.accessioned2011-02-07T17:04:06Z
dc.date.issued2008
dc.identifier.citationMurphy, Sabina A., Elliott M. Antman, Stephen D. Wiviott, Govinda Weerakkody, Giorgio Morocutti, Kurt Huber, Jose Lopez-Sendon, Carolyn H. McCabe, and Eugene Braunwald. 2008. Reduction in recurrent cardiovascular events with prasugrel compared with clopidogrel in patients with acute coronary syndromes from the TRITON-TIMI 38 trial. European Heart Journal 29(20): 2473-2479.en_US
dc.identifier.issn0195-668Xen_US
dc.identifier.issn1522-9645en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4706326
dc.description.abstractAims: In the TRITON-TIMI 38 trial, greater platelet inhibition with prasugrel reduced the first occurrence of the primary endpoint (cardiovascular death, MI, or stroke) compared with clopidogrel in patients with an acute coronary syndrome (ACS) undergoing planned percutaneous coronary intervention. We hypothesized that prasugrel would reduce not only first events but also recurrent primary endpoint events and therefore total events compared with clopidogrel. Methods and results: Poisson regression analysis was performed to compare the number of occurrences of the primary endpoint between prasugrel and clopidogrel in TRITON-TIMI 38. Landmark analytic methods were used to evaluate the risk of a recurrent primary endpoint event following an initial non-fatal endpoint event. Among patients with an initial non-fatal event, second events were significantly reduced with prasugrel compared to clopidogrel (10.8 vs. 15.4%, HR 0.65, 95% CI 0.46–0.92; P = 0.016), as was CV death following the non-fatal event (3.7 vs. 7.1%, HR 0.46, 95% CI 0.25–0.82; P = 0.008). Overall there was a reduction of 195 total primary efficacy events with prasugrel vs. clopidogrel (rate ratio 0.79, 95% CI 0.71–0.87; P < 0.001). Recurrent bleeding events occurred infrequently (TIMI major non-CABG bleeds: four with prasugrel and two with clopidogrel). Study drug discontinuation was frequent following the initial major bleeding event (42% of patients discontinued study drug). Conclusion: While standard statistical analytic techniques for clinical trials censor patients who experience a component of the primary composite endpoint, total cardiovascular events remain important to both patients and clinicians. Prasugrel, a more potent anti-platelet agent, reduced both first and subsequent cardiovascular events compared with clopidogrel in patients with ACS.en_US
dc.language.isoen_USen_US
dc.publisherOxford University Pressen_US
dc.relation.isversionofdoi://10.1093/eurheartj/ehn362en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567025/pdf/en_US
dash.licenseLAA
dc.subjectacute coronary syndromeen_US
dc.subjectpercutaneous coronary interventionen_US
dc.subjectprasugrelen_US
dc.subjectclopidogrelen_US
dc.titleReduction in Recurrent Cardiovascular Events with Prasugrel Compared with Clopidogrel in Patients with Acute Coronary Syndromes from the TRITON-TIMI 38 Trialen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalEuropean Heart Journalen_US
dash.depositing.authorAntman, Elliott Marshall
dc.date.available2011-02-07T17:04:06Z
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dash.affiliation.otherHMS^Academic Programsen_US
dc.identifier.doi10.1093/eurheartj/ehn362*
dash.contributor.affiliatedAntman, Elliott
dash.contributor.affiliatedWiviott, Stephen
dash.contributor.affiliatedMcCabe, Carolyn Hoss
dash.contributor.affiliatedBraunwald, Eugene


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