Eliaz R, Mengesha B, Ovdat T, et al. - Treatment with prasugrel, vs ticagrelor, results in superior clinical outcomes in ST-elevation myocardial infarction (STEMI) patients, but not in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients.

• This study included ACS (acute coronary syndrome) patients undergoing in-hospital percutaneous coronary intervention, enrolled in the ACSIS (Acute Coronary Syndrome Israeli Survey), and treated with prasugrel (n=1126) or ticagrelor (n=817).

• No significant difference in in-hospital complication rates was found between groups.

• In propensity score matched STEMI patients, higher 30-day re-hospitalization rate, 30-day MACE (the composite of death, MI, stroke and urgent revascularization), and 1-year mortality rates were noted in the ticagrelor group vs the prasugrel group.

• In NSTE-ACS patients, there was no link between drug choice and outcomes.

• Cox regression analysis applied on the entire cohort revealed lower 1-year mortality with prasugrel in STEMI patients but not in NSTE-ACS patients (p for interaction 0.03).