Heart Center of Chonnam National University Hospital.
Gachon University Gil Medical Center.
Circ J. 2018 Jun 25;82(7):1866-1873. doi: 10.1253/circj.CJ-18-0112. Epub 2018 Apr 12.
There is little information regarding comparison of ticagrelor and prasugrel in patients with ST-segment elevation myocardial infarction (STEMI). We sought to compare clinical outcomes between ticagrelor and prasugrel in STEMI.
A total of 1,440 patients with STEMI who underwent successful primary percutaneous coronary intervention were analyzed; the data were obtained from the Korea Acute Myocardial Infarction Registry-National Institutes of Health. Of the patients, 963 received ticagrelor, and 477 received prasugrel. The primary study endpoint was 12-month major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). MACE occurred in 91 patients (6.3%) over the 1-year follow-up, and there were no differences in the incidence of MACE (hazard ratio [HR] 1.20, 95% confidence interval [CI] 0.76-1.91, P=0.438) between the 2 groups. Analysis by propensity score matching (429 pairs) did not significantly affect the results. The incidence of in-hospital major bleeding events was still comparable between the 2 groups (2.4% vs. 2.5%, odds ratio 0.75, 95% CI 0.30-1.86, P=0.532), and there was no significant difference in the incidence of MACE (5.4% vs. 5.8%, HR 0.98, 95% CI 0.56-1.74, P=0.951) after matching.
Ticagrelor and prasugrel showed similar efficacy and safety profiles for treating STEMI in this Korean multicenter registry.
关于替格瑞洛和普拉格雷在 ST 段抬高型心肌梗死（STEMI）患者中的比较，相关信息较少。我们旨在比较替格瑞洛和普拉格雷在 STEMI 患者中的临床结局。
共分析了 1440 例接受成功直接经皮冠状动脉介入治疗的 STEMI 患者；这些数据来自韩国急性心肌梗死注册研究-美国国立卫生研究院。其中，963 例患者接受替格瑞洛治疗，477 例患者接受普拉格雷治疗。主要研究终点为 12 个月时的主要不良心脏事件（MACE），包括心脏死亡、心肌梗死（MI）和靶血管血运重建（TVR）。在 1 年随访期间，91 例患者（6.3%）发生 MACE，两组间 MACE 的发生率无差异（风险比 [HR] 1.20，95%置信区间 [CI] 0.76-1.91，P=0.438）。通过倾向评分匹配（429 对）分析并未显著影响结果。两组住院期间大出血事件的发生率仍相似（2.4% vs. 2.5%，比值比 0.75，95%CI 0.30-1.86，P=0.532），且匹配后 MACE 的发生率也无显著差异（5.4% vs. 5.8%，HR 0.98，95%CI 0.56-1.74，P=0.951）。
在这项韩国多中心注册研究中，替格瑞洛和普拉格雷在治疗 STEMI 方面显示出相似的疗效和安全性。
