Response by Motovska et al to Letter Regarding Article, “Prasugrel Versus Ticagrelor in Patients With Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: Multicenter Randomized PRAGUE-18 Study”
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Post hoc analyses of studies comparing new P2Y12 inhibitors with clopidogrel have provided information about the efficacy and safety of the drugs in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. The TRITON study (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel) compared prasugrel to clopidogrel using a 300-mg loading dose. The PLATO study (Platelet Inhibition and Patient Outcomes) compared ticagrelor to a double (600-mg) loading dose of clopidogrel. The design of the PLATO study allowed therapy with clopidogrel before randomization; 97.3% of patients in the ticagrelor arm who underwent primary percutaneous coronary intervention for ST-elevation myocardial infarction were treated with clopidogrel before the procedure (94.9% of these patients received a dose ≥300 mg).1
If multiple drugs of 1 class …