Authors' results and conclusions: Compared to aspirin alone, dual therapy (clopidogrel plus aspirin) produces a significant reduction in major cardiovascular events in ACS patients and in those undergoing PCI, with an increased risk of major bleeding. Compared to the standard loading dose (300 mg), an increased loading dose of clopidogrel (600 mg) reduces the incidence of major cardiovascular events without an increase in major bleeding in patients undergoing PCI. Compared to clopidogrel, prasugrel decreases the rates of ischemic events including stent thrombosis, but increases the risk of major and fatal bleeding in patients undergoing PCI, without changes in overall mortality. Compared to clopidogrel, ticagrelor decreases the rate of all-cause mortality, vascular mortality, or myocardial infarction, without an increase in the rate of major bleeding, but with an increase in the risk of major non-CABG bleeding. Prasugrel and ticagrelor have similar efficacy and safety, except prasugrel is more protective for stent thrombosis, with an increased risk of major bleeding.

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf//htis/aug-2011/RC0287_Treatments_for_ACS_final_abs.pdf

Year Published: 2011

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)