Prasugrel Shows Advantage Over Ticagrelor In Diabetic Patients After Stent Placement

One twelvemonth of dual antiplatelet therapy pinch 1 of 2 potent P2Y12 inhibitors-ticagrelor aliases prasugrel-in group pinch Type 1 aliases Type 2 glucosuria who had received a drug-eluting stent did not connection nan aforesaid level of use astatine preventing stent clotting, bosom attacks and bleeding complications, according to a preliminary late-breaking subject position coming astatine nan American Heart Association's Scientific Sessions 2025. The meeting, Nov. 7-10, successful New Orleans, is simply a premier world speech of nan latest technological advancements, investigation and evidence-based objective believe updates successful cardiovascular science.

The TUXEDO-2 study is simply a randomized objective proceedings evaluating percutaneous coronary involution strategies, including stent choice, revascularization approach, and antiplatelet therapy, successful 1,800 adults successful India pinch Type 1 aliases Type 2 glucosuria and multivessel disease. All of nan patients enrolled successful nan study had 1 of 2 circumstantial drug-eluting stents implanted aft a percutaneous coronary involution to clear a blockage. Stents are implanted to summation humor travel successful a narrowed aliases blocked vessel, and drug-eluting stents are coated pinch a medicine to thief trim nan consequence of re-narrowing of nan stents.

This portion of nan study specifically focused connected comparing 2 antiplatelet medications, prasugrel and ticagrelor, which were prescribed to nan patients, on pinch aspirin, aft nan stent procedure. Researchers reviewed nan complaint of stroke, bosom attack, bleeding complications aliases decease aft 1 twelvemonth of nan medicine regimens.

Our findings bespeak that prasugrel whitethorn perchance beryllium nan amended prime for patients pinch Type 1 aliases Type 2 diabetes. We were amazed by nan results because we hypothesized that ticagrelor should beryllium arsenic bully aliases possibly moreover amended than prasugrel. It's important to take nan correct medicine, and astatine slightest from our data, we cannot opportunity that ticagrelor and prasugrel are interchangeable."

Sripal Bangalore, M.D., M.H.A., FAHA, lead study author, professor of medicine astatine NYU Grossman School of Medicine, New York City

The study found:

• The superior composite result of bosom attack, stroke, bleeding complications aliases decease occurred astatine a complaint of 16.57% successful nan ticagrelor group and 14.23% successful nan prasugrel group.
• The complaint of non-fatal bosom onslaught was 5.96% successful nan ticagrelor group and 5.21% successful nan prasugrel group; nan complaint of awesome bleeding successful nan ticagrelor group was 8.41% and 7.14% successful nan prasugrel group. The complaint of decease successful patients taking ticagrelor was 5.03% and 3.67% successful nan prasugrel group.

"Currently, these medications are treated arsenic interchangeable. However, our findings supply grounds that they mightiness beryllium a spot different," Bangalore said. "For individuals pinch Type 1 aliases Type 2 glucosuria and analyzable coronary disease, location whitethorn beryllium an advantage to curen pinch prasugrel complete ticagrelor, and importantly, nan 2 should not beryllium utilized interchangeably."

Dual antiplatelet therapy, which includes aspirin positive a P2Y12 inhibitor agent, prevents humor clots and reduces nan consequence of adverse cardiac events successful group pinch acute coronary syndrome. The 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for nan Management of Patients With Acute Coronary Syndromes recommends astatine slightest 1 twelvemonth of dual antiplatelet therapy for each patients aft implantation of a drug-eluting stent.

Study details, inheritance and design:

• The TUXEDO-2 study was conducted astatine 66 wellness attraction sites crossed India. Enrollment for nan proceedings was from 2020 to 2024 and nan study researchers assessed nan outcomes of participants aft they had been randomly assigned to person 1 of 2 types of stents, arsenic good arsenic 2 different types of dual anti-platelet therapy.
• The study included 1,800 adults (average property of 60 years; 71% men and 29% women) pinch Type 1 aliases Type 2 glucosuria and multivessel coronary disease.
• The patients had undergone percutaneous coronary involution (to reconstruct humor travel to nan artery), and a drug-eluting stent had been implanted.
• About 1 4th of nan study participants were taking insulin; astir 79% had acute coronary artery syndrome; and astir 85% 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 patients successful nan 2 medicine groups were akin successful position of age, sex, ethnicity and bosom wellness status.
• The medicine comparison study successful nan proceedings followed these patients for a year, and different parts of nan Tuxedo proceedings will proceed for 5 years.

Study limitations included that patients and physicians knew to which medicine nan patients were assigned. In addition, compliance pinch nan assigned curen wasn't assessed, meaning that location was nary measurement to beryllium definite study participants took each medications precisely arsenic prescribed. In addition, nan study was done only successful India, truthful findings whitethorn not use to countries pinch different wellness systems aliases populations.