News | November 03, 2007

New Antiplatelet Therapy May Improve Outcomes

November 4, 2007 – The antiplatelet drug prasugrel offered greater benefit than current, standard therapy for patients who have undergone percutaneous coronary intervention (PCI), according to a late-breaking clinical trial presented at the American Heart Association’s Scientific Sessions 2007.

Dual antiplatelet therapy with aspirin plus a prescription antiplatelet drug is standard treatment for helping reduce complications such as heart attacks or clotting in stents in patients with acute coronary syndromes (ACS) who have undergone PCI to open blocked coronary arteries.

TRITON - TIMI 38, a large, international, double-blind phase 3 trial, compared single dosage regimens of prasugrel, a novel antiplatelet drug, and clopidogrel, a commonly used prescription antiplatelet. Both medications are in a class of drugs called thienopyridines.

At these doses, “Prasugrel was been shown to be more potent, work more quickly and have more consistent antiplatelet effects than standard, approved doses of clopidogrel,” said Elliott M. Antman, M.D., professor of medicine at Harvard Medical School and director of the Samuel A. Levine Cardiac Unit at Brigham and Women’s Hospital in Boston, Mass.

TRITON - TIMI 38 enrolled 13,608 patients with moderate to high-risk ACS who were scheduled to undergo PCI. Participants were randomized at 707 sites in 30 countries. Patients were given either prasugrel (60 mg as a one-time “loading” dose, followed by a daily 10 mg maintenance dose) or clopidogrel (300 mg loading dose and a daily 75 mg maintenance dose) for up to 15 months following PCI.

The primary efficacy endpoint (death from cardiovascular causes, heart attack or stoke) was significantly lower on prasugrel (12.1 percent of patients randomized to clopidogrel and 9.9 percent of patients randomized to prasugrel (HR 0.81[0.73-0.90], P=0.0004)), meeting the primary hypothesis of superiority. This dose of prasugrel was also associated with a significantly lower incidence of stent thrombosis (HR 0.48[0.36-0.64], P

“Although clopidogrel is a highly effective antiplatelet drug, many patients who receive it still have serious ischemic events despite reliably taking the drug,” said Antman. “The benefits of the higher degrees of inhibition of platelet aggregation achieved with the doses of prasugrel that we tested in TRITON-TIMI 38 represent the latest advance in antiplatelet therapy for patients with an acute coronary syndrome.”

Antman said there were some patients who did not do as well with this dosage of prasugrel, such as those who had a history of prior stroke, were elderly and had a low body weight. Potential modifications of the maintenance dose will be guided by ongoing analyses of a pharmacokinetic substudy in TRITON-TIMI 38.

Support for this study was provided by Daiichi Sankyo Co. Ltd and Eli Lilly & Co.

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.

For more information: www.americanheart.org

Related Content

Titanium-Nitride-Oxide Stent Superior to Bioabsorbable DES in Acute Coronary Syndrome Patients

Image courtesy of Hexacath

News | Stents Drug Eluting | May 31, 2018
Late-breaking trial results presented at the EuroPCR Congress, May 21-24 in Paris, France, found the Optimax titanium-...
Orsiro DES Shows Lowest Two-Year Target Lesion Failure in BIO-RESORT Trial
News | Stents Drug Eluting | May 31, 2018
Two-year outcome data from the BIO-RESORT randomized controlled trial were presented in a late-breaking clinical trials...
OCT Reveals Excellent Healing Profile for Complex CAD Patients With Resolute Onyx DES
News | Stents Drug Eluting | May 29, 2018
Investigators recently unveiled clinical data from the independently run Onyx 1-Month OCT Study showing strong early...
Abbott's Xience Sierra Stent Receives FDA Approval
Technology | Stents Drug Eluting | May 25, 2018
Abbott announced it received approval from the U.S. Food and Drug Administration (FDA) for Xience Sierra, the newest...
Medtronic Launches 2 mm Onyx DES
Technology | Stents Drug Eluting | February 26, 2018
February 26, 2018 – Designed specifically for small vessels, Medtronic plc announced U.S.
Detroit Medical Center Heart Hospital Uses Michigan's First EluNIR Drug-Eluting Stent
News | Stents Drug Eluting | February 19, 2018
February 19, 2018 — The Detroit Medical Center’s (DMC) interventional cardiology team at Heart Hospital recently beca
Biotronik Symposium Highlights Differing Roles of Drug-Eluting Stents and Magnesium Scaffolds in Clinical Practice
News | Stents Drug Eluting | January 25, 2018
January 25, 2018 – Data presented at the Biotronik-sponsored...
The Abbott Absorb Bioresorbable Vascular Scaffold (BVS) bioabsorbable stent.

The Abbott Absorb Bioresorbable Vascular Scaffold (BVS).

Feature | Stents Drug Eluting | January 17, 2018 | Dave Fornell
There was no shortage of interest in bioresorbable stent technologies at the many sessions offered on this topic or b
Cordis and Medinol Announce FDA Approval of EluNIR Drug-Eluting Stent System
Technology | Stents Drug Eluting | December 13, 2017
Cordis, a Cardinal Health company, and Medinol recently announced U.S. Food and Drug Administration (FDA) approval of...
The Xience Sierra stent.
Technology | Stents Drug Eluting | November 09, 2017
November 9, 2017 — Abbott received European CE mark for Xience Sierra, the newest generation of the company's Xience
Overlay Init