Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety

<b>Introduction</b>: A direct head-to-head comparison between potent P2Y12 inhibitors: prasugrel versus ticagrelor is still lacking. <b>Purpose</b>: In this single-center study, we sought to address the efficacy and safety of these two third-generation antiplatelet drugs, aft...

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Main Authors: Fadel Bahouth, Boris Chutko, Haitham Sholy, Sabreen Hassanain, Gassan Zaid, Evgeny Radzishevsky, Ibrahem Fahmwai, Mahmod Hamoud, Nemer Samnia, Johad Khoury, Idit Dobrecky-Mery
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Language:English
Published: MDPI AG 2025-05-01
Series:Medicines
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Online Access:https://www.mdpi.com/2305-6320/12/2/13
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author Fadel Bahouth
Boris Chutko
Haitham Sholy
Sabreen Hassanain
Gassan Zaid
Evgeny Radzishevsky
Ibrahem Fahmwai
Mahmod Hamoud
Nemer Samnia
Johad Khoury
Idit Dobrecky-Mery
author_facet Fadel Bahouth
Boris Chutko
Haitham Sholy
Sabreen Hassanain
Gassan Zaid
Evgeny Radzishevsky
Ibrahem Fahmwai
Mahmod Hamoud
Nemer Samnia
Johad Khoury
Idit Dobrecky-Mery
author_sort Fadel Bahouth
collection DOAJ
description <b>Introduction</b>: A direct head-to-head comparison between potent P2Y12 inhibitors: prasugrel versus ticagrelor is still lacking. <b>Purpose</b>: In this single-center study, we sought to address the efficacy and safety of these two third-generation antiplatelet drugs, after about a decade of practical use. <b>Methods</b>: A retrospective observational study included all patients who were admitted with acute coronary syndrome between January 2010 and December 2019 and were discharged with aspirin and either prasugrel or ticagrelor after percutaneous coronary intervention. Patients were divided into two groups based on the dual antiplatelet drugs prescribed. Primary endpoint: A composite endpoint of cardiovascular death, recurrent coronary syndrome, or ischemic stroke at one year. Secondary endpoint: Significant bleeding according to the BARC classification (types 3, 4, or 5). <b>Results</b>: During this period, 746 patients met the inclusion criteria. The primary endpoint was reached in 70 patients (9.4%): 24 patients (8.0%) in the group treated with ticagrelor and 46 patients (10.3%) in the group treated with prasugrel (<i>p</i>-value = 0.303). In terms of safety events, significant bleeding was not statistically different between the ticagrelor and prasugrel groups: 13 (2.9%) vs. 9 (3%), respectively (<i>p</i>-value = 0.9). More patients discontinued their treatment before the end of the year among those treated with ticagrelor compared to those treated with prasugrel (16.7% vs. 9.6%, <i>p</i>-value = 0.003). <b>Conclusions</b>: There was no significant difference in the occurrence of recurrent cardiac events, stroke, or cardiovascular death, nor significant bleeding among ACS patients treated either with prasugrel or ticagrelor.
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spelling doaj-art-c3ec0675b9ce414a9c57bf27023fc40c2025-08-20T02:20:58ZengMDPI AGMedicines2305-63202025-05-011221310.3390/medicines12020013Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and SafetyFadel Bahouth0Boris Chutko1Haitham Sholy2Sabreen Hassanain3Gassan Zaid4Evgeny Radzishevsky5Ibrahem Fahmwai6Mahmod Hamoud7Nemer Samnia8Johad Khoury9Idit Dobrecky-Mery10Department of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, IsraelPulmonology Division, Carmel Medical Center, Haifa 3436212, IsraelDepartment of Cardiology, Bnai-Zion Medical Center, Haifa 31096, Israel<b>Introduction</b>: A direct head-to-head comparison between potent P2Y12 inhibitors: prasugrel versus ticagrelor is still lacking. <b>Purpose</b>: In this single-center study, we sought to address the efficacy and safety of these two third-generation antiplatelet drugs, after about a decade of practical use. <b>Methods</b>: A retrospective observational study included all patients who were admitted with acute coronary syndrome between January 2010 and December 2019 and were discharged with aspirin and either prasugrel or ticagrelor after percutaneous coronary intervention. Patients were divided into two groups based on the dual antiplatelet drugs prescribed. Primary endpoint: A composite endpoint of cardiovascular death, recurrent coronary syndrome, or ischemic stroke at one year. Secondary endpoint: Significant bleeding according to the BARC classification (types 3, 4, or 5). <b>Results</b>: During this period, 746 patients met the inclusion criteria. The primary endpoint was reached in 70 patients (9.4%): 24 patients (8.0%) in the group treated with ticagrelor and 46 patients (10.3%) in the group treated with prasugrel (<i>p</i>-value = 0.303). In terms of safety events, significant bleeding was not statistically different between the ticagrelor and prasugrel groups: 13 (2.9%) vs. 9 (3%), respectively (<i>p</i>-value = 0.9). More patients discontinued their treatment before the end of the year among those treated with ticagrelor compared to those treated with prasugrel (16.7% vs. 9.6%, <i>p</i>-value = 0.003). <b>Conclusions</b>: There was no significant difference in the occurrence of recurrent cardiac events, stroke, or cardiovascular death, nor significant bleeding among ACS patients treated either with prasugrel or ticagrelor.https://www.mdpi.com/2305-6320/12/2/13acute coronary syndrometicagrelorprasugreldual anti platelet drugs
spellingShingle Fadel Bahouth
Boris Chutko
Haitham Sholy
Sabreen Hassanain
Gassan Zaid
Evgeny Radzishevsky
Ibrahem Fahmwai
Mahmod Hamoud
Nemer Samnia
Johad Khoury
Idit Dobrecky-Mery
Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
Medicines
acute coronary syndrome
ticagrelor
prasugrel
dual anti platelet drugs
title Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
title_full Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
title_fullStr Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
title_full_unstemmed Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
title_short Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety
title_sort ticagrelor versus prasugrel in acute coronary syndrome real world treatment and safety
topic acute coronary syndrome
ticagrelor
prasugrel
dual anti platelet drugs
url https://www.mdpi.com/2305-6320/12/2/13
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