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EuroPCR 2014 examines whether science translates into practice with new session format
Date:5/22/2014

scheduled to undergo coronary angiography within two to 48 hours after randomisation. Patients were randomly assigned to receive prasugrel before the angiography (pre-treatment group, 30mg loading dose) or placebo (control group). When PCI was indicated, an additional 30mg of prasugrel was given in the pre-treatment group at the time of PCI and 60mg of prasugrel was given in the control group.

Reviewing the ACCOAST trial data, Peter Juni, Clinical Trials Unit and Institute of Social and Preventative Medicine, University of Bern, Switzerland, said: "In NSTE-ACS patients managed invasively within 48 hours of admission, pre-treatment with prasugrel did not reduce major ischaemic events through 30 days, but increased major bleeding complications."

Andreas Baumbach added, "The ACCOAST trial is a wonderful trial that has tried to answer the clinically relevant question of whether pre-treatment with prasugrel would be beneficial to patients. The study was conducted within a practice environment that was situated with rapid access to a cath lab, showed that there is no benefit for pre-treatment with this half dose of prasugrel. It also showed more bleeding events in patients who received this dose. There are a number of very interesting questions about this trial, the main being that we are not sure whether we can extrapolate these results to pre-treatment with other drugs that have been shown to be beneficial in other trials."

With regard to how the ACCOAST results applied to clinical practice, Baumbach noted that judging by the show of hands in yesterday's session, the majority of the audience would not change their current practice. "The trial is relevant, but we need new trials to see whether we can advance the treatment for those patients," he said.


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Contact: Isabelle Uzielli
iuzielli@europcr.com
EuroPCR
Source:Eurekalert

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