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Minerva Cardiology and Angiology 2021 Jun 17

DOI: 10.23736/S2724-5683.21.05591-5


Ticagrelor versus Prasugrel in acute coronary syndrome: sex-specific analysis from the RENAMI Registry

Sara AL RAISI 1, Majd PROTTY 1, 2, Sergio RAPOSEIRAS-ROUBÍN 3, Fabrizio D'ASCENZO 4, Emad ABU-ASSI 3, Albert ARIZA-SOLÉ 5, Sergio MANZANO-FERNÁNDEZ 6, Christian TEMPLIN 7, Lazar VELICKI 8, 9, Ioanna XANTHOPOULOU 10, Enrico CERRATO 11, Giorgio QUADRI 12, Andrea ROGNONI 13, Giacomo BOCCUZZI 14, Andrea MONTABONE 14, Salma TAHA 15, Alessandro DURANTE 16, Sebastiano GILI 7, Giulia MAGNANI 7, Michele AUTELLI 4, Alberto GROSSO 4, Pedro FLORES-BLANCO 6, Ferdinando VARBELLA 12, María CESPÓN-FERNÁNDEZ 3, Diego GALLO 17, Umberto MORBIDUCCI 17, Alberto DOMINGUEZ-RODRIGUEZ 18, Angel CEQUIER 5, Fiorenzo GAITA 4, Dimitrios ALEXOPOULOS 10, Marco VALGIMIGLI 18, Andrés ÍÑIGUEZ-ROMO 3, Tim KINNAIRD 1

1 Cardiology Department, University Hospital of Wales, Cardiff, Wales, UK; 2 Systems Immunity University Research Institute, Cardiff University, Cardiff, UK; 3 Cardiology Department, University Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain; 4 Department of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy; 5 Cardiology Department, Hospital de Bellvitge, Barcelona, Spain; 6 Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; 7 Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland; 8 Medical Faculty, University of Novi Sad, Novi Sad, Serbia; 9 Institute of Cardiovascular Diseases Voivodina, Sremska Kamenica, Serbia; 10 University Patras Hospital, Atenas, Rion, Patras, Greece; 11 Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; 12 Department of Cardiology, Infermi Hospital, Rivoli, Turin, Italy; 13 Coronary Care Unit and Catheterization Laboratory, A.O.U. Maggiore della Carità, Novara, Italy; 14 Department of Cardiology, S.G. Bosco Hospital, Turin, Italy; 15 Department of Cardiology, Faculty of Medicine, Assiut University, Asiut, Egypt; 16 Unità Operativa di Cardiologia, Ospedale Valduce, Como, Italy; 17 PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy

BACKGROUND: The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS population.
METHODS: Data from the multicentre REgistry of New Antiplatelets in patients with Myocardial Infarction for 4424 ACS patients who underwent PCI and were treated with ticagrelor or prasugrel between 2012 to 2016 were analysed. Mean follow-up was 17 ± 9 months.
RESULTS: After propensity score matching, there was no significant difference in the occurrence of primary endpoint of net adverse cardiac events between the ticagrelor and prasugrel in men (HR: 0.94; 95% CI: 0.69-1.29; p=0.71), or women (HR: 1.17; 95% CI: 0.63-2.20; p=0.62; p interaction [sex] = 0.40). Similarly, no differences were found in the occurrence of any of the secondary endpoints (MACE, all cause death, reinfarction, stent thrombosis, BARC major bleeding and BARC any bleeding) between the two P2Y12 groups between men and women.
CONCLUSIONS: In this real-world ACS population, no relative difference in efficacy or safety outcomes were found between ticagrelor and prasugrel between sexes.

KEY WORDS: Acute coronary syndrome; Antiplatelet therapy; Ticagrelor; Prasugrel

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