Only 9.9 percent of participants taking prasugrel died from cardiovascular causes, compared with 12.1 percent of patients taking Plavix, a 19 percent reduction. Prasugrel was also associated with a lower incidence of stent thrombosis, revascularization and heart attack.
On the other hand, the incidence of major bleeding was significantly higher with prasugrel -- 2.4 percent vs. 1.8 percent of patients on Plavix.
Still, Antman pointed out, prasugrel came out ahead.
"There were 24 fewer cardiovascular deaths with prasugrel and 16 more bleeding-related deaths so the net tally was nine fewer total deaths, which is not statistically significant," Antman said. "[But] what's important here is we believe we know where the majority of excess bleeding and most of the fatal bleeding occur -- those with prior stroke or TIA [transient ischemic attack] probably shouldn't get prasugrel, the elderly and those with a low body weight would probably benefit from a reduced maintenance dose."
A second study presented at the press conference found that a nuclear imaging technique that measures blood flow in the heart can identify which patients will benefit more from undergoing percutaneous coronary intervention than receiving medical therapy alone for blocked coronary arteries. The trial was supported by Bristol Myers-Squibb Medical Imaging and Astellas Healthcare.
Another trial found that Integrilin (eptifibatide) was as effective as ReoPro (abciximab) in restoring blood flow to the heart in patients undergoing PCI.
"Preliminary clinical events did not show any differences, therefore eptifibatide seems a valid alternative to abciximab in patients with pri
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