There is no difference in prasugrel vs ticagrelor during the first year after an acute myocardial infarction (MI), according to one-year outcomes of the PRAGUE-18 trail presented November 14, at American Heart Association (AHA) Scientific Sessions 2017, and simultaneously published in the Journal of the American College of Cardiology.

Zuzana Motovska, MD, PhD, et al., looked at 1,230 patients with acute MI treated with primary percutaneous coronary intervention who were randomized to prasugrel or ticagrelor with an intent-to-treat duration of 12 months.

Results showed that the endpoint of cardiovascular death, MI or stroke at one year occurred in 6.6% of the prasugrel patients and 5.7% of ticagrelor patients. No significant differences were found in cardiovascular death, MI, stroke, all-cause death, definite stent thrombosis, all bleeding and thrombolysis in MI major bleeding.

Further, economically motivated early post-discharge switches to clopidogrel were not associated with an increased risk of ischemic events.

The authors conclude that their findings contribute to arguments in favor of the trend toward personalization of treatment of patients with acute MI.