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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe advantage of prasugrel over clopidogrel in preventing stent thrombosis has been found to be maintained regardless of the time since the stenting procedure, the type of stent, or the ARC definition of thrombosis. The TRITON-TIMI 38 stent analysis showed that the drug led to a highly significant reduction in stent thrombosis over a broad array of clinical and procedural characteristics.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional techniques \u0026amp; devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emyocardial infarction clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethrombotic disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EThe advantage of prasugrel over clopidogrel in preventing stent thrombosis has been found to be maintained regardless of the time since the stenting procedure, the type of stent, or the ARC definition of thrombosis. The TRITON-TIMI 38 stent analysis showed that the drug led to a highly significant reduction in stent thrombosis over a broad array of clinical and procedural characteristics.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe patients who were included in the stent analysis represented a subset of patients from the main TRITON-TIMI 38 trial, which included patients with moderate-to-high-risk acute coronary syndrome who were scheduled for PCI. In that trial, 6461 patients received only bare-metal stents (BMS), and 5743 patients received only drug-eluting stents (DES). The patients were randomly assigned to antiplatelet therapy with either clopidogrel (300 mg loading dose before PCI, followed by a maintenance dose of 75 mg daily for one year) or prasugrel (loading dose of 60 mg, followed by 10 mg daily for one year). The findings of that study showed that prasugrel was associated with a 52% reduction in stent thrombosis (2.4% compared with 1.1% for clopidogrel; p\u0026lt;0.0001).\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EStephen D. Wiviott, MD, Brigham and Women\u0027s Hospital, Boston, MA, reported that the stent analysis portion of TRITON-TIMI 38 demonstrated rates of stent thrombosis for the 2 drugs that were similar to the rates in the main trial. Overall, prasugrel reduced early (within 30 days)stent thrombosis by 59% (0.64% vs 1.56%; p\u0026lt;0.0001) and late stent thrombosis by 40% (0.49% vs 0.82%; p=0.03); (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). The frequency of definite or probable stent thrombosis associated with prasugrel was significantly lower in the BMS arm (1.27% vs 2.41%; HR 0.52; p=0.0009), as well as in the DES arm (0.84% vs 2.31%; HR 0.36; p\u0026lt;0.0001).\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/8\/2\/9.1\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Comparison of Early and Late Definite\/Probable Stent Thrombosis (Any stent n=12844).\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-241483878\u0022 data-figure-caption=\u0022Comparison of Early and Late Definite\/Probable Stent Thrombosis (Any stent n=12844).\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/8\/2\/9.1\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/8\/2\/9.1\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/8\/2\/9.1\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11129\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EComparison of Early and Late Definite\/Probable Stent Thrombosis (Any stent n=12844).\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe rates of stent thrombosis associated with the 2 drugs were also consistent across the various ARC definitions of stent thrombosis. Prasugrel was associated with a 0.9% rate of definite stent thrombosis, a 1.1% rate of definite or probable thrombosis, and a 1.5% rate of definite, probable, or possible thrombosis. All of these rates were significantly lower (p\u0026lt;0.0001) than those for clopidogrel (2.0%, 2.3%, and 2.7%, respectively).\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EIn discussing the balance of efficacy and safety, Dr. Wiviott noted that prasugrel prevented stent thrombosis in 12 of 1000 patients and prevented adverse events other than stent thrombosis (cardiovascular disease, myocardial infarction, and stroke) in 15 of 1000 patients. The drug was associated with major bleeding in 5 of 1000 patients.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003E\u201cWhat TRITON-TIMI showed with respect to the prevention of stent thrombosis was clinically very important. Now we need to find ways to determine which patients are best suited for which therapies,\u201d said. Dr. Wiviott.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2008 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/8\/2\/9.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmg0p\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmg0p\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}