Not better, but similar efficacy found for low-dose Prasugrel compared to Ticagrelor in East Asian acute coronary syndrome (ACS) patients, delineated a retrospective cohort study conducted using Taiwan’s National Health and Welfare Database.

Yee-Jen Wu and colleagues compared the effectiveness and safety of Prasugrel and Ticagrelor at different doses in ACS patients. The study comprised of a large number of ACS patients (24,807) who underwent percutaneous coronary intervention between January 1, 2018, and December 31, 2020. Out of the total, 1,493 received Prasugrel low-dose and 23,314 received Ticagrelor as the standard-dose. The combination of acute myocardial infarction, ischemic stroke, and cardiovascular death was the primary effectiveness outcome, while the combination of intracranial haemorrhage and gastrointestinal bleeding was the primary safety outcome.

Results showed no noteworthy dissimilarities in the primary effectiveness or safety outcomes between the two groups. Specifically, the hazard ratio (HR) for primary effectiveness was 0.97 (95% confidence interval: 0.74–1.28), and for primary safety outcomes, it was 1.22 (95% confidence interval: 0.73–2.01).