ORIGINAL ARTICLE   

Minerva Cardiology and Angiology 2021 August;69(4):408-16

DOI: 10.23736/S2724-5683.21.05591-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Ticagrelor versus prasugrel in acute coronary syndrome: sex-specific analysis from the RENAMI Registry

Sara AL RAISI ¹, Majd PROTTY ^{1, 2}, Sergio RAPOSEIRAS-ROUBÍN ³, Fabrizio D’ASCENZO ⁴, Emad ABU-ASSI ³, Albert ARIZA-SOLÉ ⁵, Sergio MANZANO-FERNÁNDEZ ⁶, Christian TEMPLIN ⁷, Lazar VELICKI ^{8, 9}, Ioanna XANTHOPOULOU ¹⁰, Enrico CERRATO ¹¹, Giorgio QUADRI ¹², Andrea ROGNONI ¹³, Giacomo BOCCUZZI ¹⁴, Andrea MONTABONE ¹⁴, Salma TAHA ¹⁵, Alessandro DURANTE ¹⁶, Sebastiano GILI ⁷, Giulia MAGNANI ⁷, Michele AUTELLI ⁴, Alberto GROSSO ⁴, Pedro FLORES-BLANCO ⁶, Ferdinando VARBELLA ¹², María CESPÓN-FERNÁNDEZ ³, Diego GALLO ¹⁷, Umberto MORBIDUCCI ¹⁷, Alberto DOMÍNGUEZ-RODRÍGUEZ ¹⁸, Ángel CEQUIER ⁵, Fiorenzo GAITA ⁴, Dimitrios ALEXOPOULOS ¹⁰, Marco VALGIMIGLI ¹⁸, Andrés ÍÑIGUEZ-ROMO ¹³, Tim KINNAIRD ¹ ✉

¹ Department of Cardiology, University Hospital of Wales, Cardiff, Wales, UK; ² Systems Immunity University Research Institute, Cardiff University, Cardiff, UK; ³ Department of Cardiology, Álvaro Cunqueiro University Hospital, Vigo, Pontevedra, Spain; ⁴ Service of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy; ⁵ Department of Cardiology, Bellvitge Hospital, Barcelona, Spain; ⁶ Department of Cardiology, Virgen de la Arrixaca University Hospital, Murcia, Spain; ⁷ Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland; ⁸ Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; ⁹ Institute of Cardiovascular Diseases Voivodina, Sremska Kamenica, Serbia; ¹⁰ General University Hospital of Patras, Rion, Patras, Greece; ¹¹ Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; ¹² Department of Cardiology, Infermi Hospital, Rivoli, Turin, Italy; ¹³ Coronary Care Unit and Catheterization Laboratory, Maggiore della Carità University Hospital, Novara, Italy; ¹⁴ Department of Cardiology, S.G. Bosco Hospital, Turin, Italy; ¹⁵ Department of Cardiology, Faculty of Medicine, Assiut University, Asiut, Egypt; ¹⁶ Unit of Cardiology, Valduce Hospital, Como, Italy; ¹⁷ PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Polytechnical University of Turin, Turin, Italy; ¹⁸ Service of Cardiology, University Hospital of the Canary Islands, Santa Cruz de Tenerife, Spain

BACKGROUND: The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS population.
METHODS: Data from the multicenter REgistry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) for 4424 ACS patients who underwent PCI and were treated with ticagrelor or prasugrel between 2012 to 2016 were analyzed. Mean follow-up was 17±9 months.
RESULTS: After propensity score matching, there was no significant difference in the occurrence of primary endpoint of net adverse cardiac events between ticagrelor and prasugrel in men (HR: 0.94; 95% CI: 0.69-1.29; P=0.71), or women (HR: 1.17; 95% CI: 0.63-2.20; P=0.62; P interaction [sex] = 0.40). Similarly, no differences were found in the occurrence of any of the secondary endpoints (MACE, all cause death, re-infarction, stent thrombosis, BARC major bleeding and BARC any bleeding) between the two P2Y12 groups between men and women.
CONCLUSIONS: In this real-world ACS population, no relative difference in efficacy or safety outcomes were found between ticagrelor and prasugrel between sexes.

KEY WORDS: Acute coronary syndrome; Dual anti-platelet therapy; Ticagrelor; Prasugrel