Abstract 10481: Predictors of Bleeding Events in Patients Treated With Prasugrel or Clopidogrel: Insights From the TRITON-TIMI 38 Trial
Introduction: The balance between risk (bleeding) and benefit (ischemia protection) in choosing the intensity of dual antiplatelet therapy is a key consideration in therapeutic decision making. Therefore, we tried to identify parameters that independently predict bleeding in patients with an acute coronary syndrome and planned early percutaneous coronary intervention enrolled in the TRITON-TIMI 38 trial that compared clopidogrel versus prasugrel.
Methods: Cox regression analysis adjusted for treatment, type of qualifying event, and baseline and procedural variables was used to determine the best predictors for TIMI major or minor bleeding in patients who received at least one dose of study medication (either clopidogrel or prasugrel).
Results: From the 13,421 patients included in our analysis, 534 incurred a TIMI major or minor bleeding event. The adjusted predictors for TIMI major or minor bleeding in the overall cohort are listed in the table according to their strength of association with the risk of bleeding.
Conclusion: The major predictors of bleeding in patients treated with prasugrel or clopidogrel are patient characteristic such as age, gender or peripheral arterial disease together with procedural characteristics. Prasugrel is an independent predictor of TIMI major or minor bleeding, but its association with bleeding is weaker than that of other independent predictors.
- Acute coronary syndromes
- Antiplatelet drugs
- Clinical trials
- Percutaneous coronary intervention
- © 2010 by American Heart Association, Inc.