Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
N Engl J Med. 2012 Oct 4;367(14):1297-309. doi: 10.1056/NEJMoa1205512. Epub 2012 Aug 25.

Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.

Collaborators (1063)

Roe MT, Armstrong PW, Fox KA, Prabhakaran D, White HD, Ohman E, Ardissino D, Aylward PE, Bassand JP, Bhatt DL, Boden WE, Castillo VR, Chua T, Cinteza M, Clemmensen P, Corbalan R, Cornel JH, Dalby AJ, Erlinge D, Foley DP, Fridrich V, Gasparovic V, Ge J, Goodman S, Gottlieb S, Goudev A, Gratsiansky N, Gurbel PA, Hamm CW, Hochman JS, Huber K, Jeong MH, Jun-Ren Z, Leiva-Pons JL, Lopez-Sendon J, Luscher T, Martinez F, McGuire DK, Merkely B, Mogrovejo WE, Nicolau J, Ohman E, Oto A, Parkhomenko A, Pavlides G, Petrauskiene B, Providencia L, Roe M, Ruzyllo W, Sritara P, Syvänne M, Topacio G, Tseng CD, Verheugt F, Widimsky P, Wiviott SD, Zambahari R, Van de Werf F, Budaj A, Gersh BJ, Montalescot G, Pocock SJ, Wilcox RG, Williams DO, Wilson M, Mehta RH, Alexander JH, Kong DF, Lopes R, Mahaffey KW, Melloni C, Newby L, Shah BR, Tricoci P, George DJ, Beaven AW, Blackwell KL, Morse MA, Onken JE, Ready NE, Strickler JH, Zafar S, Lokhnygina Y, Hafley G, Pieper K, Stevens S, Schibler T, Chan M, Chin CT, Gharacholou S, Subherwal S, McLendon R, Winters KJ, Marshall D, Macias W, LeNarz L, Petijean H, Plat F, van Kranen R, Zamoryakhin D, Albisu J, Alvarez C, Amuchastegui M, Astesiano AL, Beloscar J, Bergallo J, Bono J, Bordonava A, Botta CE, Budassi N, Caccavo A, Cartasegna L, Colombo H, Costello R, Covelli G, De Valais F, Dran R, Duronto E, Forte EH, Garcia DF, Garcia Escudero A, Hominal M, Hrabar AD, Ibañez JO, Jure H, Leon de la Fuente R, Lobo Marquez L, Luciardi H, Luquez H, Marino J, Martingano R, Moises Azize G, Nul D, Patocchi C, Piombo A, Prado A, Rodriguez M, Romero Acuña A, Scaro GB, Sosa Liprandi A, Varini SD, Vigo SJ, Aroney G, Arstall M, Blenkhorn A, Carroll P, Chew D, Collins N, Hammett C, Lee A, Marrinan M, Roberts-Thomson P, Waites J, Benzer W, Huber K, Lang I, Podczeck-Schweighofer A, Baetslé P, Beauloye C, De Tollenaere M, Lancellotti P, Marechal P, Van Dorpe A, Albuquerque D, Andrade Lotufo P, Ardnt M, Arminio G, Alves da Cost FA, Baracioli LM, Bertolim Precoma D, Carvalho Neuenschwander F, Damiao Gomes Seabra M, De Souza J, Duda NT, Dutra OP, Feitosa A, Filho H, Finimundi HC, Gomes M, Gubolino L, Guimarães AE, Hernandes M, Jardim CA, Kunz Sebba Barroso de Souza W, Leaes PE, Maia LN, Manenti E, Marin Neto JA, Marino R, Michalaros Y, Mora Junior R, Moraes Junior JB, Nogueira Liberato de Sousa L, Pimentel Filho P, Polanczyk C, Rabelo Alves A Jr, Ramos R, Reis G, Rocha Faria Neto J, Rossi dos Santos F, Saporito W, Saraiva JF, Sartori PC, Scholz Issa J, Silva Junior D, Sousa A, Teixeira M, Zimmermann SL, Lazov P, Tokmakova M, Penchev K, Petrov I, Baldjiev E, Georgiev P, Hergeldjieva V, Manolova A, Dimov B, Goudev A, Mihov A, Pencheva G, Raev D, Ramshev K, Tumbev H, Tzekova M, Boichev B, Kadiiski A, Devedzhiev T, Bakbak A, Berlingieri J, Burstein J, Déry JP, Heath J, Huynh T, Kassam S, Kostuk W, Labonte R, MacCallum C, Nawaz S, Quraishi AU, Senaratne M, Syan G, Syan R, Vizel S, Castro P, Florenzano F, Lamich R, Manriquez L, Potthoff S, Stockins B, Bugueño C, Cobos J, Sepulveda P, Opazo M, Montecinos H, Ge J, Ke Y, Chen YD, Chen J, Wang J, Li W, Xu B, Ma G, Li Z, Sun Y, Tang J, Yuan Z, Tang L, Zhou Y, He Q, Xu J, Zhang H, Yang K, Zhou S, Chen J, Zhao S, Zheng Z, Li X, Wang D, Hong X, Guan R, Wang L, Huang H, Xia Y, Hao Y, Zhang S, Zhao X, Liu X, Yan J, Huang Y, Wang B, Vallejo GS, Bohorquez R, Gomez NI, Fernandez R, Mayorga LE, Gomez J, Quintero A, Figueredo A, Senior J, Accini JL, Roncallo E, Frischwasser S, Sanchez MS, Bouzid Y, Ciglenecki N, Certic JF, Grman J, Sutalo K, Bergovec M, Gasparovic V, Knezevic A, Mirat J, Padovan M, Car S, Samardzic P, Bagatin J, Kraus L, Coufal Z, Janota T, Kettner J, Linhart A, Hondl M, Osmancik P, Padour M, Telekes P, Vojacek J, Vojtisek P, Francek L, Sedlon P, Brønnum-Schou J, Hansen P, Clemmensen P, Nielsen H, El-Etreby A, El Hawary A, El Rakshy Y, Mowafy A, Ragy H, Reda A, Sabri S, Nyman K, Laine M, Bressollette E, Rifai A, Danchin N, Ovize M, Cottin Y, Farah B, Furber A, Coste P, Elbaz M, Morel O, Schiele F, Elhadad S, Belhassane A, El Mansour N, Leroy F, Coisne D, Ferrari E, Nguyen-Khac O, Range G, Moulin F, Poulard JE, Sechtem U, Kaelsch T, Ebelt H, Gawaz M, Genth-Zotz S, Moellmann H, Heuer H, Kadel C, Klein H, Werner G, Boudriot E, Kruells-Muench J, Baer F, Alexopoulos D, Manolis A, Platogiannis D, Anastasiou-Nana M, Nanas I, Cokkinos D, Fotiadis I, Koliopoulos N, Moschos N, Olympios C, Ples Z, Illyes L, Csikasz J, Zolyomi S, Kis E, Kovacs Z, Lupkovics G, Nagy A, Regos L, Tomcsanyi J, Janosi A, Medvegy M, Szakal I, Vertes A, Merkely B, Szalai G, Banker D, Dani S, Kumar S, Sarna MK, Seerangachar RK, Deshpande A, Khan IA, Gupta SK, Dharmadhikari A, Babu P, Fulwani M, Kerkar PG, Varma S, Singh P, Babu R, Menon J, Sengupta S, Sathe S, Premchand RK, Kalra R, Kalashetti S, Pai V, Bose V, Jain V, Kale V, Benjarge P, Ghaisas N, Thanvi S, Durgaprasad R, Kulkarni RL, Joshi H, Abyankar A, Bisne V, Chopra V, Reddy P, Sarma R, Garg N, Agarwal DK, Arneja J, Bandyopadhyay S, Bharani A, Yadav R, Dutta S, Chidambaram N, Dande A, Gadkari M, Grant P, Khan A, Gupta R, Gupta JB, Shetty G, Lavhe PV, Jain R, Joseph J, Calambur N, Joseph S, Mardikar H, Mathur A, Mohanan P, Kumbla M, Nair T, Nambiar A, Jathappa N, Parale G, Patel T, Puri A, Rao B, Saligrama R, Sathe S, Sawhney J, Sethi S, Singh B, Kumar S, Srinivas A, Jagadesa BS, Foley D, Mahon N, Mulvihill N, Nash P, Arad T, Balkin J, Francis A, Gottlieb S, Hammerman H, Hasin Y, Katz A, Kracoff O, Marmor A, Mosseri M, Atar S, Roth A, Zahger D, Turgeman Y, Weiss A, De Luca M, Antonelli G, Piovaccari G, Barbiero M, Cuccia C, De Servi S, Fedele F, Golino P, Manari A, Menozzi A, Berti S, Moretti L, Musumeci G, Pajes G, Paloscia L, Mos L, Salvioni A, Volpe M, De Luca G, Astarita C, Merlini P, Di Lorenzo L, Fattore L, Ambrosio G, Mircoli L, Galvani M, Cavallini C, Nassiacos D, Scioli R, Jeong MH, Yoon J, Kim DK, Hur SH, Bae JH, Rha SW, Lee SR, Kim KS, Ko YG, Jeong JO, Lee SK, Hong TJ, Kim M, Hwang JY, Shin EK, Kim SW, Anusauskiene J, Dambrauskaite A, Jarasuniene D, Raugaliene R, Babarskiene MR, Petrauskiene B, Ahmad WA, Yusof Z, Maskon O, Ong TK, Abdullah HN, Zambahari R, Chandran A, Chong YS, Lee CY, Ramanathan L, Sciberras R, Xuereb RG, Fajardo P, Ramos-Lopez G, Alcocer MA, Ramirez MC, Ibarra MO, Leiva-Pons JL, Esperón GL, Díaz CS, Hamer A, Elliott J, Harding S, Hart H, Castillo BG, Ortega RN, Frago G, Henriquez F, Acosta DC, Zambrano EC, Mogrovejo W, Chois A, Gamio CF, Barrera MA, Cabrera J, Dextre LZ, Reyes M, Tellez D, Castillo R, Chavez C, Godoy A, Llerena N, Morales CA, Habaluyas R, Topacio G, Rogelio G, Ramos EJ, Chua P, Mendoza V, Tirador L, Abanilla J, Edmilao MI, Coching RM, Morales D, Dalkowski M, Sciborski R, Lewczuk J, Hoffmann A, Lesnik J, Andruszkiewicz B, Wojciechowski D, Kus W, Jozwa R, Kasprzak J, Lubinski A, Karczmarczyk A, Wojcik J, Gruchala M, Bartus S, Bronisz M, Mirek-Bryniarska E, Dudek D, Gorny J, Grzywna R, Kawka-Urbanek T, Niezgoda K, Olszewski R, Ogorek M, Gniot J, Nessler J, Ponikowski P, Wita K, Zinka E, Zmudka K, Ruzyllo W, Szelemej R, Moreira J, Bastos JM, Ferreira J, Martins D, Providência L, Ribeiro VG, Silva G, Seixo F, Morais J, Rinaldi R, Rodriguez-Ospina L, Colon-Hernandez P, Matei C, Tatu-Chitoiu GP, Iordachescu-Petica D, Teodorescu I, Ochean V, Constantinescu MC, Stanciulescu GE, Bobescu E, Bolohan FR, Coman IM, Creteanu M, Dan GA, Dobre I, Ionescu P, Minescu B, Olinic DM, Pop C, Stamate SC, Cinteza M, Gurevich V, Bichan N, Baranov E, Zateyshchikov D, Barbarich V, Gordeev I, Tereshchenko S, Dovgalevskiy Y, Boyarkin M, Shogenov Z, Suprun E, Shalaev S, Arutyunov G, Supryadkina T, Perepech N, Nikolskaya I, Rossovskaya M, Khaisheva L, Simanenkov V, Boldueva S, Zrazhevskiy K, Barbarash O, Egorova L, Gratsiansky N, Markov V, Novikova N, Alexeeva N, Ermoshkina L, Ishmurzin G, Miloradovic V, Pavlovic M, Ilic S, Krotin M, Neskovic A, Otasevic P, Vasiljevic-Pokrajcic Z, Ostojic M, Chua T, Chan MY, Goh PP, Kokles M, Bugan V, Urban M, Sirotiakova J, Belicova M, Duris T, Poliacik P, Slanina M, Fridrich V, Letcher G, Abelson M, Dalby A, Gould T, Manga P, Pillay T, Theron H, Venter T, van Zyl L, Essop M, van der Merwe N, Alegret JM, Gomez DL, Vera TR, Bruguera i Cortada J, Garcia JH, Dalli E, Paz MA, Ridocci F, Coronado JL, Romero C, Urbano RH, Carlsson R, Erlinge D, Falck G, Gallino A, Linka A, Tseng CD, Lai WT, Shyu KG, Li AH, Chiang CE, Hou JY, Sritara P, Kuanprasert S, Srimahachota S, Wongvipaporn C, Laothavorn P, Krittayaphong R, Tangsuntornwiwat S, Moleerergpoom W, Kaewsuwanna P, Sakulsaengprapha T, Viboolkitvarakul N, Buakhamsri A, Braam R, Basart DC, Troquay RP, Herrman JP, van der Heijden DJ, Broeders M, Römer T, Post JC, Viergever E, Zwart P, Cornel JH, Groutars R, Breedveld R, Ronner E, Hoedemaker G, van Kalmthout P, Kuijper A, Geertman JH, Hamer B, Werter C, Westendorp I, Kruik HJ, Zouari SB, Boughzala E, Boujnah R, Gamra H, Haouala H, Kammoun S, Ben Khalfallah A, Maatouk F, Ural D, Kutlu M, Sahin M, Ebinc H, Kucukoglu S, Demirtas M, Kirma C, Altun A, Aydinlar A, Aydogdu S, Cayli M, Bozkurt E, Buyukoner EE, Erdogan D, Acikel M, Oto A, Ozdemir M, Ozdemir K, Yazici M, Goloborodko B, Nykonov V, Vakaliuk I, Yagensky A, Vatutin M, Shcherbak V, Kovalskyy I, Bagriy A, Ushakov O, Zhurba S, Sierkova V, Bashkirtsev O, Vasylenko A, Karpenko Y, Kaydashev I, Amosova K, Batushkin V, Faynyk A, Horbach L, Karpenko O, Koval' O, Kraiz I, Parkhomenko A, Potapenko P, Rudenko L, Malynovsky Y, Tseluyko V, Volkov V, Prokhorov O, Sarkar D, Moriarty A, El-Harari M, Brigden G, Qureshi N, Alamgir F, de Belder A, Keeling P, Cooke J, Brown N, Junejo S, Vuyyuru R, Connolly D, Kadr H, Griffiths H, Tang K, Cotton J, Barr C, Lindsay S, Venkataraman A, Rittoo D, Jacob A, Watkin R, Lang C, Pye M, Chambers J, Mavromatis K, Rossi P, Ahmad A, Anderson H, Roberts J, Klugherz B, Haidar A, Downes T, Russo D, Wallace W, Bhagwat R, Mathew T, Jetty P, Henderson D, Dy J, Isserman S, Kondle V, Quintana O, Brener S, Masud Z, Vijay N, Jain M, Longo J, Safley D, Pancholy S, Shaoulian E, Allan J, Bazzi A, Chahin J, Shurmur S, Santos R, Goldberg J, Gigliotti O, Irimpen A, Khan M, Kusnick B, Treasure C, Rogers J, Zebrack J, Turner M, Adjei N, Ingram C, Mathis C, Buchanan W, Heins G, Ahsan C, Anderson J, Atassi K, Bachinsky W, Baig M, Rodriguez A, Tang A, Foreman R, Berlin H, Bouchard A, Thew S, Borromeo S, Bowden W, Boyek T, Arter J, Blair J, Chandna H, Katz J, Conn E, Connelly T, Del Core M, Shanes J, Dotani I, Drenning D, Bustros N, Elliott J, Fastabend C, Flores E, Goudreau E, Gredler F, Greenfield R, Guidera S, Gogia H, Hearne S, Hermany P, Taheri H, Izzo M, Jaffrani N, Johnson G, Keedy D, Waxman F, Kesselbrenner M, Floro J, Korban E, Labroo A, Lui H, Georgeson S, Breall J, Baman R, Mandak J, Marais H, Lee D, Meisner J, Micale P, Meymandi S, Vicari R, Mouhaffel A, Moscoso R, Papademetriou V, Piegari G, Promisloff S, Rivera E, Rogers W, Roth D, Sadler D, Canto J, Schmedtje J, Shaikh S, Shalev Y, Sharma M, Rahman A, Schwartz S, Sporn D, Staniloae C, Tami L, Barnum O, Tu T, Tuma J, Wali A, Welka S, Wilson V, Younis L, Zakhary B, Ziperman D, Singh N, Kukuy E, Leimbach W, Chang M, Carter M, Simpson P, Miklin J, Niess G, Schaefer S, Lambert C, Soh E, Heintz K, Miller J, Chandrashekhar Y, Pappas J, Rashid HU, Wright W, Rees A, Bach R, Wu W, Singhi S, Quyyumi A, Lau T, Nobel J, Kamdar A, Kabour A, Stys T, Keller N, Kumar A, Danisa K, Smith S, Espinoza A, Deac D, Roberts D, Gumm D, Saucedo J, Gimple L, Weinstein D, Blonder R, Moran M, Iwaoka R, Bayron C, Tejada L, White L, Ingersoll H, Casterella P, Chiaramida S, Harris J, Rodriguez R, Vo A, Dave K, Khan M, Giacomini J, Kotha P, Park C, Arif I, McGrew F, Atieh M, Huang X, Zarrella G, McGarvey J, Koganti D, Albirini A, Keller N, Kozman H, Slepian M, Quion JA, Ramanathan K, Bessen M, Rafael A, Aycock G, Lee D.

Author information

  • 1Duke Clinical Research Institute and Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA. matthew.roe@duke.edu

Abstract

BACKGROUND:

The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated.

METHODS:

In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel.

RESULTS:

At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval [CI], 0.79 to 1.05; P=0.21). Similar results were observed in the overall population. The prespecified analysis of multiple recurrent ischemic events (all components of the primary end point) suggested a lower risk for prasugrel among patients under the age of 75 years (hazard ratio, 0.85; 95% CI, 0.72 to 1.00; P=0.04). Rates of severe and intracranial bleeding were similar in the two groups in all age groups. There was no significant between-group difference in the frequency of nonhemorrhagic serious adverse events, except for a higher frequency of heart failure in the clopidogrel group.

CONCLUSIONS:

Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

Comment in

PMID:
22920930
[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Write to the Help Desk