DURHAM, N.C. The first trial to study patients with acute coronary syndrome who do not undergo coronary stenting or bypass surgery found no significant difference between two anti-clotting drugs prasugrel and clopidogrel in preventing the first occurrence of death, heart attack or stroke, according to Duke University Medical Center cardiologists.
The study also showed no difference in serious bleeding complications.
At the same time, the Duke researchers observed an unexpected reduction in heart attack, stroke and death among patients treated with prasurgrel beyond one year of treatment. The researchers say this potential time-dependent benefit requires further exploration.
The results were presented by the Duke researchers at the European Society of Cardiology Scientific Sessions in Munich, Germany today, and published online in the New England Journal of Medicine.
"If you look at this study as a comparison of two drugs, it doesn't tell the whole story," says E. Magnus Ohman, M.D., a professor of medicine at Duke and chairman of the TRILOGY ACS study. "This is a unique patient population that has never before been studied."
Acute coronary syndrome (ACS) refer to a group of conditions that include heart attacks and chest pain caused by clogged coronary arteries. To date, most trials evaluating anti-clotting drugs for ACS patients have focused on patients who undergo revascularization procedures such as stent implantation with percutaneous coronary intervention and coronary artery bypass surgery to restore blood flow.
Up to 60 percent of ACS patients worldwide undergo revascularization procedures according to published data. The remaining 40 percent are managed solely with drug therapy. These patients are at higher risk for repeated cardiovascular-related events, such as heart attack, stroke, and death.
"Optimizing medical therapy for these patients is extremely important," Ohman says.'/>"/>
|Contact: Debbe Geiger|
Duke University Medical Center