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Multiple Types of Heart Attacks Reduced by Prasugrel in TRITON-TIMI 38 Trial
Date:5/21/2009

Universal Definition of Myocardial Infarction provided jointly by leading international cardiology societies

TOKYO and INDIANAPOLIS, May 21 /PRNewswire-FirstCall/ -- Investigators from the Phase III TRITON-TIMI 38 study applied the new classification system for the Universal Definition of Myocardial Infarction to the results of the study and showed that patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) and taking prasugrel, as compared with patients taking clopidogrel (Plavix(R)/Iscover(R)), experienced reduced risk of heart attack regardless of heart-attack type (procedural related or spontaneous), size or timing over a 15-month period. The new Universal Definition of Myocardial Infarction (1) was developed in 2007 by the Joint European Society of Cardiology, American College of Cardiology, American Heart Association and the World Heart Federation Task Force. This post hoc analysis was published in Circulation online on May 18, 2009.(2)

In this post hoc analysis, the incidence of non-procedural heart attack in patients treated with prasugrel compared with patients treated with clopidogrel was 2.8 percent vs. 3.7 percent, respectively (p=0.0013). The risk of procedure-related heart attacks was 4.9 percent in patients who took prasugrel compared with 6.4 percent in patients who took clopidogrel (p=0.0002). Non-procedure-related heart attacks included spontaneous heart attacks, which could be differentiated from procedure-related heart attacks that were associated with the artery-opening procedure known as PCI, or with stent thrombosis.

The analysis reported in this paper was not pre-specified in the TRITON-TIMI 38 study because the Universal Definition of Myocardial Infarction was published after the trial started.

"Our findings provide a more complete characterization of the effect of prasugrel on new or recurrent heart attacks," said David A. M
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SOURCE Eli Lilly and Company
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