Prasugrel Head-to-Head Study Showed Reduced Cardiovascular Events in Diabetes Patients by 30 Percent Compared with Clopidogrel

Sub-group analysis of landmark trial showed prasugrel substantially

02-Sep-2008 - Germany

Patients who were diabetic and diagnosed with acute coronary syndromes (ACS) were 40 percent less likely to suffer a heart attack if they were treated with prasugrel vs. clopidogrel, according to a sub-group analysis of the TRITON-TIMI 38 trial (8.2 percent vs. 13.2 percent, P<0.001). In addition, according to this same analysis, the combined rate of cardiovascular death, non-fatal heart attack and non-fatal stroke was reduced by 30 percent in diabetes patients treated with prasugrel compared to those treated with clopidogrel (12.2 percent vs. 17.0 percent, P<0.001). In patients without diabetes, there was also improvement in outcomes with prasugrel, with the primary endpoint occurring in 9.2 percent of patients treated with prasugrel and 10.6 percent of patients treated with clopidogrel (P=0.02).

The diabetic sub-group analysis was presented by Stephen Wiviott, M.D., Assistant Professor of Medicine at Harvard Medical School and investigator with the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Brigham & Women's Hospital, Boston, USA, at the Congress of the European Society of Cardiology (ESC) in Munich, Germany. In addition, the manuscript was simultaneously published online in Circulation.

"The results observed from this sub-group analysis showed that antiplatelet therapy with prasugrel resulted in significantly greater reduction of cardiovascular events among patients with diabetes when compared to those who were treated with clopidogrel," said Wiviott.

The reduction of cardiovascular events was consistent across the sub-group of diabetes patients regardless of diabetic therapies (insulin versus no insulin). The study showed a significant relative risk reduction in the primary endpoint of cardiovascular death, non-fatal heart attack and non-fatal stroke with prasugrel, 37 percent for insulin treated and 26 percent (P=0.001) for non-insulin treated diabetics. There was also a significantly lower rate of stent thrombosis among diabetes patients treated with prasugrel, resulting in a 48 percent relative risk reduction in stent thrombosis compared with clopidogrel (3.6 percent vs. 2.0 percent, P=0.007).

https://www.bionity.com/en/news/86450/prasugrel-head-to-head-study-showed-reduced-cardiovascular-events-in-diabetes-patients-by-30-percent-compared-with-clopidogrel.html