11. Antithrombotic therapies

Reduced-dose Prasugrel vs. standard Clopidogrel in elderly patients

Elderly ACS-2 study
Objective
to compare the clinical outcomes of a low maintenance dose of 5 mg prasugrel with standard clopidogrel 75 mg in elderly patients following PCI
Study
multicentre, open-label, blinded end point, randomised trial
Population
elderly patients >74 years with acute coronary syndrome
Endpoints
composite all-cause death, MI, disabling stroke and rehospitalisation for cardiovascular causes or bleeding at 1 year
Conclusion
low dose 5 mg Prasugrel did not reduce adverse events compared to standard 75 mg Clopidogrel in elderly patients undergoing PCI for acute coronary syndrome
Savonitto et al. Circulation. 2018;137:2435-45
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