The following is a summary of “Incidence and pattern of urgent revascularization in acute coronary syndromes treated with ticagrelor or prasugrel,” published in the May 2024 issue of Cardiology by Aytekin et al.

Ticagrelor and prasugrel are two antiplatelet medicines observed and compared during the ISAR-REACT 5 trial to identify their effectiveness and safety for patients with acute coronary syndrome (ACS) treated with invasive procedures.

Researchers conducted a prospective study to assess the impact of ticagrelor and prasugrel on the frequency and patterns of urgent revascularization in patients with ACS undergoing percutaneous coronary intervention (PCI).

They analyzed 5 patients in ISAR-REACT who opted for PCI. The primary endpoint was urgent revascularization at 12 months, with a secondary focus on the pattern of revascularization procedures (Target vessel revascularization (TVR) or non-target vessel revascularization (NTVR) patterns). 

The results showed that from the selected 3,377 patients, 1,676 were given ticagrelor, and 1,701 were given prasugrel. After 12 months, urgent revascularization was higher in the ticagrelor group (6.8% vs. 5.2%; HR 1.32, 95% CI 1.00-1.75; P=0.051), driven by more urgent NTVR (3.8% vs. 2.4%; HR 1.62, 95% CI 1.09-2.41; P=0.017). Urgent TVR rates were similar (3.3% vs. 3.0%; HR 1.13, 95% CI 0.77-1.65, P=0.546).

Investigators concluded that patients with ACS who were treated with PCI had more urgent revascularizations after 12 months with ticagrelor than prasugrel due to increased urgent procedures on distant coronary vessels.

Source: link.springer.com/article/10.1007/s00392-024-02454-x