Ticagrelor or prasugrel in patients with acute coronary syndrome with off-hour versus on-hour presentation: a subgroup analysis of the ISAR-REACT 5 trial.
Acute coronary syndromes
Off-hour presentation
Percutaneous coronary intervention
Prasugrel
Ticagrelor
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
31
03
2022
accepted:
09
05
2022
medline:
30
3
2023
pubmed:
6
7
2022
entrez:
5
7
2022
Statut:
ppublish
Résumé
To assess the efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndrome (ACS) presenting during off- and on-hours. The efficacy and safety of ticagrelor versus prasugrel in patients with ACS according to time of hospital presentation remain unknown. This post hoc analysis of the ISAR-REACT 5 trial included 1565 patients with ACS presenting off-hours and 2453 patients presenting on-hours, randomized to ticagrelor or prasugrel. The primary endpoint was a composite of death, myocardial infarction, or stroke; the safety endpoint was Bleeding Academic Research Consortium (BARC) type 3-5 bleeding, both at 12 months. The primary endpoint occurred in 80 patients (10.4%) in the ticagrelor group and 57 patients (7.3%) in the prasugrel group in patients presenting off-hours (hazard ratio [HR] = 1.45; 95% confidence interval [CI] 1.03-2.03; P = 0.033), and 104 patients (8.5%) in the ticagrelor group and 80 patients (6.7%) in the prasugrel group in patients presenting on-hours (HR = 1.29 [0.97-1.73]; P = 0.085), without significant treatment arm-by-presentation time interaction (P In patients with ACS planned to undergo an invasive treatment strategy, time of presentation (off-hours vs. on-hours) does not interact significantly with the relative efficacy and safety of ticagrelor vs. prasugrel. NCT01944800.
Sections du résumé
OBJECTIVES
OBJECTIVE
To assess the efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndrome (ACS) presenting during off- and on-hours.
BACKGROUND
BACKGROUND
The efficacy and safety of ticagrelor versus prasugrel in patients with ACS according to time of hospital presentation remain unknown.
METHODS
METHODS
This post hoc analysis of the ISAR-REACT 5 trial included 1565 patients with ACS presenting off-hours and 2453 patients presenting on-hours, randomized to ticagrelor or prasugrel. The primary endpoint was a composite of death, myocardial infarction, or stroke; the safety endpoint was Bleeding Academic Research Consortium (BARC) type 3-5 bleeding, both at 12 months.
RESULTS
RESULTS
The primary endpoint occurred in 80 patients (10.4%) in the ticagrelor group and 57 patients (7.3%) in the prasugrel group in patients presenting off-hours (hazard ratio [HR] = 1.45; 95% confidence interval [CI] 1.03-2.03; P = 0.033), and 104 patients (8.5%) in the ticagrelor group and 80 patients (6.7%) in the prasugrel group in patients presenting on-hours (HR = 1.29 [0.97-1.73]; P = 0.085), without significant treatment arm-by-presentation time interaction (P
CONCLUSIONS
CONCLUSIONS
In patients with ACS planned to undergo an invasive treatment strategy, time of presentation (off-hours vs. on-hours) does not interact significantly with the relative efficacy and safety of ticagrelor vs. prasugrel.
CLINICAL TRIAL REGISTRATION
BACKGROUND
NCT01944800.
Identifiants
pubmed: 35789430
doi: 10.1007/s00392-022-02040-z
pii: 10.1007/s00392-022-02040-z
pmc: PMC10050020
doi:
Substances chimiques
Prasugrel Hydrochloride
G89JQ59I13
Ticagrelor
GLH0314RVC
Platelet Aggregation Inhibitors
0
Banques de données
ClinicalTrials.gov
['NCT01944800']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
518-528Subventions
Organisme : German Center for Cardiovascular Research (DZHK); Deutsches Herzzentrum München
ID : FKZ 81X1600501
Informations de copyright
© 2022. The Author(s).
Références
Clin Res Cardiol. 2008 Oct;97(10):742-7
pubmed: 18465106
Clin Pharmacokinet. 2020 May;59(5):545-566
pubmed: 32056160
N Engl J Med. 2009 Sep 10;361(11):1045-57
pubmed: 19717846
Am J Cardiol. 2013 Apr 1;111(7):946-54
pubmed: 23340031
Angiology. 2017 Oct;68(9):807-815
pubmed: 28173713
N Engl J Med. 2007 Nov 15;357(20):2001-15
pubmed: 17982182
N Engl J Med. 1987 Jun 11;316(24):1514-8
pubmed: 3587281
J Am Heart Assoc. 2020 Mar 3;9(5):e015726
pubmed: 32122217
Thromb Haemost. 2019 Apr;119(4):660-667
pubmed: 30695790
Am J Cardiol. 2014 Mar 1;113(5):798-802
pubmed: 24393257
BMJ. 2014 Jan 21;348:f7393
pubmed: 24452368
N Engl J Med. 2013 Sep 12;369(11):999-1010
pubmed: 23991622
JAMA. 2005 Aug 17;294(7):803-12
pubmed: 16106005
Catheter Cardiovasc Interv. 2010 Oct 1;76(4):484-90
pubmed: 20882649
Circulation. 2008 May 13;117(19):2502-9
pubmed: 18427127
Eur Heart J Acute Cardiovasc Care. 2017 Feb;6(1):3-9
pubmed: 26714975
PLoS One. 2017 Apr 7;12(4):e0175485
pubmed: 28388683
JACC Cardiovasc Interv. 2011 Mar;4(3):270-8
pubmed: 21435603
Acute Card Care. 2013 Sep;15(3):52-7
pubmed: 23738606
Can Pharm J (Ott). 2013 Sep;146(5):262-9
pubmed: 24093037
Croat Med J. 2009 Oct;50(5):476-82
pubmed: 19839071
PLoS One. 2011;6(9):e24549
pubmed: 21931750
Eur Heart J Cardiovasc Pharmacother. 2018 Jul 1;4(3):166-171
pubmed: 29370383
JACC Cardiovasc Interv. 2019 Aug 26;12(16):1521-1537
pubmed: 31202949
Am Heart J. 2015 Jan;169(1):62-8
pubmed: 25497249
N Engl J Med. 2007 Mar 15;356(11):1099-109
pubmed: 17360988
Herz. 2016 Dec;41(8):725-731
pubmed: 27193907
Crit Care Med. 2006 Apr;34(4):1016-24
pubmed: 16505703
Am J Cardiol. 2014 Jan 15;113(2):262-9
pubmed: 24295548
Ann Intern Med. 2020 Sep 15;173(6):436-444
pubmed: 32687741
Emerg Med J. 2007 Aug;24(8):588-91
pubmed: 17652691