Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Ischemic Heart Disease
Comparison of Clinical Outcomes Between Ticagrelor and Prasugrel in Patients With ST-Segment Elevation Myocardial Infarction ― Results From the Korea Acute Myocardial Infarction Registry-National Institutes of Health ―
Min Chul KimMyung Ho JeongDoo Sun SimYoung Joon HongJu Han KimYoungkeun AhnTae Hoon AhnKi Bae SeungDong-Ju ChoiHyo-Soo KimHyeon Cheol GwonIn Whan SeongKyoung-Kook HwangShung Chull ChaeSeung Ho HurKwang Soo ChaSeok Kyu OhJei Keon ChaeKorea Acute Myocardial Infarction-National Institutes of Health Registry Investigators
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2018 Volume 82 Issue 7 Pages 1866-1873


Background:There is little information regarding comparison of ticagrelor and prasugrel in patients with ST-segment elevation myocardial infarction (STEMI). We sought to compare clinical outcomes between ticagrelor and prasugrel in STEMI.

Methods and Results:A total of 1,440 patients with STEMI who underwent successful primary percutaneous coronary intervention were analyzed; the data were obtained from the Korea Acute Myocardial Infarction Registry-National Institutes of Health. Of the patients, 963 received ticagrelor, and 477 received prasugrel. The primary study endpoint was 12-month major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). MACE occurred in 91 patients (6.3%) over the 1-year follow-up, and there were no differences in the incidence of MACE (hazard ratio [HR] 1.20, 95% confidence interval [CI] 0.76–1.91, P=0.438) between the 2 groups. Analysis by propensity score matching (429 pairs) did not significantly affect the results. The incidence of in-hospital major bleeding events was still comparable between the 2 groups (2.4% vs. 2.5%, odds ratio 0.75, 95% CI 0.30–1.86, P=0.532), and there was no significant difference in the incidence of MACE (5.4% vs. 5.8%, HR 0.98, 95% CI 0.56–1.74, P=0.951) after matching.

Conclusions:Ticagrelor and prasugrel showed similar efficacy and safety profiles for treating STEMI in this Korean multicenter registry.

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