Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes Índice de masa corporal y eficacia y seguridad del ticagrelor frente al prasugrel en pacientes con síndrome coronario agudo

Lahu S, Behnes M, Ndrepepa G, Neumann FJ, Sibbing D, Bernlochner I, Menichelli M, Mayer K, Richardt G, Gewalt S, Angiolillo DJ, Coughlan JJ, Aytekin A, Witzenbichler B, Hochholzer W, Cassese S, Kufner S, Xhepa E, Sager HB, Joner M, Fusaro M, Laugwitz KL, Schunkert H, Schüpke S, Kastrati A, Akin I (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Revista Espanola De Cardiologia Elsevier España (Elsevier Doyma) / Sociedad Española de Cardiología

Book Volume: 75

Pages Range: 748-756

Journal Issue: 9

DOI: 10.1016/j.recesp.2021.11.006

Abstract

Introduction and objectives: The efficacy and safety of ticagrelor vs prasugrel in patients with acute coronary syndromes (ACS) according to body mass index (BMI) remain unstudied. We assessed the efficacy and safety of ticagrelor vs prasugrel in patients with ACS according to BMI. Methods: Patients (n = 3987) were grouped into 3 categories: normal weight (BMI < 25 kg/m2; n = 1084), overweight (BMI ≥ 25 to < 30 kg/m2; n = 1890), and obesity (BMI ≥ 30 kg/m2; n = 1013). The primary efficacy endpoint was the 1 year incidence of all-cause death, myocardial infarction, or stroke. The secondary safety endpoint was the 1 year incidence of Bleeding Academic Research Consortium type 3 to 5 bleeding. Results: The primary endpoint occurred in 63 patients assigned to ticagrelor and 39 patients assigned to prasugrel in the normal weight group (11.7% vs 7.5%; HR, 1.62; 95%CI, 1.09-2.42; P =.018), 78 patients assigned to ticagrelor and 58 patients assigned to prasugrel in the overweight group (8.3% vs 6.2%; HR, 1.36; 95%CI, 0.97-1.91; P =.076), and 43 patients assigned to ticagrelor and 37 patients assigned to prasugrel in the obesity group (8.6% vs 7.3%; HR, 1.18; 95%CI, 0.76-1.84; P =.451). The 1-year incidence of bleeding events did not differ between ticagrelor and prasugrel in patients with normal weight (6.5% vs 6.6%; P =.990), overweight (5.6% vs 5.0%; P =.566) or obesity (4.4% vs 2.8%; P =.219). There was no significant treatment arm-by-BMI interaction regarding the primary endpoint (Pint =.578) or secondary endpoint (Pint =.596). Conclusions: In patients with ACS, BMI did not significantly impact the treatment effect of ticagrelor vs prasugrel in terms of efficacy or safety. Clinical Trial Registration: NCT01944800.

Involved external institutions

Deutsches Herzzentrum München DE Germany (DE) Universitätsklinikum Mannheim DE Germany (DE) Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH DE Germany (DE) Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK e.V.) DE Germany (DE) Ospedale Fabrizio Spaziani IT Italy (IT) Segeberger Kliniken DE Germany (DE) University of Florida US United States (USA) (US) HELIOS Kliniken DE Germany (DE)

How to cite

APA:

Lahu, S., Behnes, M., Ndrepepa, G., Neumann, F.J., Sibbing, D., Bernlochner, I.,... Akin, I. (2022). Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes Índice de masa corporal y eficacia y seguridad del ticagrelor frente al prasugrel en pacientes con síndrome coronario agudo. Revista Espanola De Cardiologia, 75(9), 748-756. https://dx.doi.org/10.1016/j.recesp.2021.11.006

MLA:

Lahu, Shqipdona, et al. "Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes Índice de masa corporal y eficacia y seguridad del ticagrelor frente al prasugrel en pacientes con síndrome coronario agudo." Revista Espanola De Cardiologia 75.9 (2022): 748-756.

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