Comparative Study Finds Higher Rates Of Adverse Events With Ticagrelor

One twelvemonth of curen pinch either of 2 beardown blood-thinning medications—ticagrelor and prasugrel—by group pinch type 1 aliases type 2 glucosuria who had a drug-eluting stent placed successful their bosom to dainty coronary artery blockages did not connection nan aforesaid level of use to forestall stent clotting, bosom attacks, and bleeding complications, according to findings presented during a preliminary late-breaking subject convention during nan American Heart Association's Scientific Sessions 2025 successful New Orleans connected November 10.

"Our results propose that prasugrel whitethorn beryllium nan amended prime for patients pinch type 1 aliases type 2 diabetes," said study lead writer Sripal Bangalore, MD, head of investigation astatine NYU Langone's Cardiac Catheterization Laboratory and successful nan Department of Medicine's Leon H. Charney Division of Cardiology astatine NYU Grossman School of Medicine.

The results were unexpected, arsenic we initially hypothesized that ticagrelor would beryllium arsenic effective, if not better, than prasugrel. These findings item nan value of selecting nan correct medication, arsenic our information bespeak that ticagrelor and prasugrel are not interchangeable."

Sripal Bangalore, Cardiac Catheterization Laboratory, NYU Langone

The TUXEDO-2 study is simply a randomized objective proceedings designed to measure strategies for treating coronary artery illness among 1,800 adults successful India pinch type 1 aliases type 2 glucosuria and multivessel disease. The proceedings focused connected stent selection, revascularization techniques, antiplatelet therapy, and different approaches. All participants received 1 of 2 circumstantial drug-eluting stents during a percutaneous coronary involution to unfastened a blocked artery and reconstruct humor flow. These stents are coated pinch medicine to thief forestall nan treated alloy from narrowing again.

This portion of nan study specifically focused connected comparing nan antiplatelet medications prasugrel and ticagrelor, which were prescribed to nan patients, on pinch aspirin, aft nan stent procedure. Dr. Bangalore and nan investigation squad reviewed nan complaint of stroke, bosom attack, bleeding complications, and decease aft 1 twelvemonth of nan medicine regimens.

Study findings:

• The superior mixed result of bosom attack, stroke, bleeding complications, and decease occurred astatine a 16.57 percent complaint successful patients taking ticagrelor compared to 14.23 percent successful those taking prasugrel.
• Nonfatal bosom attacks occurred successful 5.96 percent of nan ticagrelor group versus 5.21 percent of nan prasugrel group, while awesome bleeding events were reported successful 8.41 percent of ticagrelor patients compared to 7.14 percent successful those who utilized prasugrel. Death rates were besides higher for ticagrelor patients, astatine 5.03 percent, compared to 3.67 percent for patients taking prasugrel.
• Worse outcomes were observed pinch ticagrelor successful patients pinch glucosuria long of little than 5 years (HR=1.63; 95% CI 1.10-2.42) and successful those pinch a precocious consequence of bleeding (HR=1.61; 95% CI 1.02-2.53).

"These medications are often considered interchangeable, but our findings propose important differences," said Dr. Bangalore. "For individuals pinch type 1 aliases type 2 glucosuria and analyzable coronary disease, prasugrel whitethorn connection chopped advantages complete ticagrelor. This investigation highlights nan request for a much personalized attack to treatment, arsenic nan 2 narcotics should not beryllium utilized interchangeably."

Dual antiplatelet therapy, combining aspirin and a P2Y12 inhibitor medication, plays a important domiciled successful preventing humor clots and reducing nan consequence of superior heart-related events successful group pinch acute coronary syndrome. According to nan "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for nan Management of Patients With Acute Coronary Syndromes," continued dual antiplatelet therapy is recommended for astatine slightest 1 twelvemonth for each patients who person a drug-eluting stent.

Study details, background, and design:

• The TUXEDO-2 study was conducted astatine 66 healthcare sites crossed India. Enrollment for nan proceedings was conducted from 2020 to 2024, and nan study researchers assessed participants' outcomes aft they had been randomly assigned to person 1 of nan 2 types of stents, arsenic good arsenic 2 types of dual antiplatelet therapy.
• The study included 1,800 adults (the mean property was 60; 71 percent were men and 29 percent were women) pinch type 1 aliases type 2 glucosuria and multivessel coronary illness who underwent percutaneous coronary involution (to reconstruct humor travel to nan artery) and a drug-eluting stent was implanted.
• About one-quarter of nan study participants were taking insulin, astir 79 percent had acute coronary artery syndrome, and astir 85 percent had triple alloy disease.
• The superior objective proceedings is evaluating nan information and efficacy of percutaneous coronary involution pinch 2 drug-eluting stents successful patients pinch type 1 aliases type 2 glucosuria and multivessel coronary disease. The nonsubjective of this study was a randomized comparison of ticagrelor versus prasugrel, successful summation to aspirin, to measure imaginable effect connected bosom attack, stroke, awesome bleeding, complications and death.
• The 2 diligent groups were akin crossed age, sex, ethnicity, and bosom wellness status.
• The proceedings is ongoing and will proceed to travel these patients for astir 5 years aft stent implantation.

Study limitations included that some patients and physicians were alert of nan assigned medications, which could present bias. Additionally, curen compliance was not monitored, truthful it's unclear whether participants consistently took their medications arsenic prescribed.