Associations between Complex PCI and Prasugrel or Clopidogrel use in Patients with Acute Coronary Syndromes undergoing PCI: From the PROMETHEUS Study

Conclusions Despite the use of contemporary techniques, ACS patients undergoing complex PCI had significantly higher rates of 1-year MACE. Adjusted magnitude of treatment effects with prasugrel versus clopidogrel were consistent in complex and non-complex PCI without evidence of interaction. Teaser In this analysis from the PROMETHEUS ACS registry (n = 19,914), complex PCI (PCI of left main/ bifurcation/ moderate-severely calcified lesion/ stent length ≥30mm) was associated with greater risk of 1-year MACE (death, myocardial infarction, stroke or unplanned revascularization; HR 1.29 [1.20-1.39]). Treatment effects with prasugrel vs. clopidogrel for risk of 1-year MACE were consistent in complex (HR 0.79 [0.68-0.92]) and non-complex PCI (HR 0.91 [0.77-1.08] (p interaction =0.281).
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research