Ticagrelor doesn't improve acute coronary syndrome compared to Prasugrel: Study

Of the 11 eligible Randomized Control Trials with 6098 patients randomized to prasugrel (n=3050) or ticagrelor (n=3048).

The results of the study were

• 180 and 207 had the composite endpoint events in the prasugrel arm and the ticagrelor arm respectively over a weighted mean follow-up period of 11±2 months.

• Compared with prasugrel, the ticagrelor group had a similar risk in the primary composite endpoint (Risk Ratio (RR)= 1.17).

• Compared to prasugrel, there was no significant difference associated with the use of ticagrelor groups with respect to stroke (RR=1.05); cardiovascular death (RR=1.01).

• BARC type 2 or above bleeding (RR=1.16); stent thrombosis (RR=1.58); all-cause death (RR=1.10) except MI (RR=1.38).

The authors concluded that "Compared with prasugrel, ticagrelor did not reduce the primary composite endpoint of MI, stroke and cardiovascular death at a weighted mean follow up of 11 months. There was no significant difference between the secondary outcomes except myocardial infarction."

Reference:

Fong L, C, W, Lee N, H, C, Yan A, T, Ng M, -Y: Comparison of Prasugrel and Ticagrelor for Patients with Acute Coronary Syndrome: A Systematic Review and Meta-analysis. Cardiology 2021. doi: 10.1159/000520673