In addition, according to this same analysis, the combined rate of cardiovascular death, non-fatal heart attack and non-fatal stroke was reduced by 30% in diabetes patients treated with prasugrel compared to those treated with clopidogrel.
In patients without diabetes, there was also improvement in outcomes with prasugrel, with the primary endpoint occurring in 9.2% of patients treated with prasugrel and 10.6% of patients treated with clopidogrel (P=0.02).
The reduction of cardiovascular events was consistent across the sub-group of diabetes patients regardless of diabetic therapies (insulin versus no insulin). The study showed a significant relative risk reduction in the primary endpoint of cardiovascular death, non-fatal heart attack and non-fatal stroke with prasugrel, 37% for insulin treated and 26% (P=0.001) for non-insulin treated diabetics.
There was also a significantly lower rate of stent thrombosis among diabetes patients treated with prasugrel, resulting in a 48% relative risk reduction in stent thrombosis compared with clopidogrel. In this sub analysis, the rates of major bleeding events were similar for prasugrel (2.5%) and clopidogrel (2.6%) among patients with diabetes, regardless of diabetes therapies (insulin versus no insulin).
Stephen Wiviott, assistant professor of medicine at Harvard Medical School, said: “The results observed from this sub-group analysis showed that antiplatelet therapy with prasugrel resulted in significantly greater reduction of cardiovascular events among patients with diabetes when compared to those who were treated with clopidogrel.”