Eli Lilly has said that antiplatelet drug prasugrel plus aspirin produced a marked and highly statistically significant reduction in the risk of coronary stent thrombosis in patients who received a stent as compared to standard therapy with clopidogrel plus aspirin in head-to-head Triton-Timi 38 trial.
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In this trial, Prasugrel has reduced the relative risk of coronary stent thrombosis (a new clot at the implanted stent site) over clopidogrel by 52% (1.13% versus 2.35%, p<0.0001). In patients who received drug-eluting stents (DES), treatment with prasugrel reduced relative risk by 64% over clopidogrel (0.84% versus 2.31%, p<0.0001), and by 48% in patients who received bare metal stents (BMS) (1.27% versus 2.41%, p=0.0009). A 19% reduction in risk was observed with prasugrel compared with clopidogrel among all patients receiving a stent (9.7% versus 11.9%, p=0.0001) in Triton's primary endpoint of cardiovascular death, non-fatal heart attack, or non-fatal stroke. A 20% relative reduction favoring prasugrel was observed in the primary endpoint in patients who received only a bare metal stent (10% versus 12.2%, p=0.003), and in patients who received only a drug-eluting stent, results showed an 18 percent relative reduction in the primary endpoint favoring prasugrel (9% versus 11.1%, p=0.019). Anthony Ware, Lilly's vice president for cardiovascular/acute care, said: "The reduction in risk seen in patients in this analysis treated with prasugrel over patients treated with clopidogrel is encouraging for high-risk patients with acute coronary syndrome being managed with percutaneous coronary intervention."
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