Abstract 20089: Comparative Efficacy and Safety of Prasugrel and Clopidogrel in Patients With STEMI Undergoing Primary PCI in the Prasugrel Core Population in Clinical Practice. Results of the Prospective ALKK-registry
Background: In the TRITON-TIMI 38 trial prasugrel reduced the combined endpoint of cardiovascular death, myocardial infarction in patients with STEMI without an increase in bleeding complications. Therefore we evaluated the impact of therapy with prasugrel on outcome in patients with primary PCI for STEMI in real life in a large number of patients in the so-called prasugrel core population.
Methods: We used the data of the ongoing prospective German ALKK-PCI registry and included patients with PCI for STEMI < 24 h duration treated in 36 centres using both clopidogrel and prasugrel. We excluded patients with prior stroke, weight 75 years.
Results: Between 2009 and 2012 a total of consecutive 6227 patients with PCI for STEMI Of these 1921 (30.8 %) were treated with prasugrel. Baseline characteristics, procedural features and in-hospital outcomes are given in the table.
In a multivariate analysis prasugrel was associated with a reduced mortality (odds ratio 0.66, 95% CI 0.44-0.99).
Conclusion: In clinical practice prasugrel compared to clopidogrel in the so-called core population is associated with a lower use of GP IIb/IIIa inhibitors and a lower mortality in patients with STEMI undergoing primary PCI. These findings support the findings of the TRITON-TIMI 38 trial.
Author Disclosures: U. Zeymer: Research Grant; Modest; Eli Lilly, Daiichi Sankyo. Speakers Bureau; Modest; Astra Zeneca, Bayer Healthcare, Boehringer Ingelheim, Daiichi Sankyo, MSD, Eli Lilly, Novartis, Sanofi. M. Hochadel: None. A. Gitt: Speakers Bureau; Modest; Daiichi Sankyo, Eli Lilly. R. Zahn: Speakers Bureau; Modest; Eli Lilly, Daiichi Sanko.
- © 2014 by American Heart Association, Inc.