Sub-group analysis of landmark trial showed prasugrel substantially reduced risk of heart attack and stent thrombosis compared with clopidogrel among ACS patients with diabetes
MUNICH, Germany, Aug. 31 /PRNewswire-FirstCall/ -- 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 today 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 medical
journal of the American Heart Association (AHA).
'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.
