Introduction

Novel antiplatelet agents emerging in a last decade have proven their effectiveness versus Clopidogrel in their respective randomized controlled trials. However, there is not enough information about comparative effectiveness of Ticagrelol versus Prasugrel in the real world setting. Only recently ISAR-REACT 5 study revealed superiority of Prasugrel as compared with Ticagrelor significantly reduced the MACE without increasing major bleeding.

Material and method

A retrospective review of the medical records and telephone survey of 1081 patients attended at the Bnai Zion Medical Center, Haifa, Israel, during 2010-2019. The review included patients admitted due Acute Coronary Syndrome and were

discharged with guidelines based therapy recommendation to continue DAPT with Aspirin and one of novel antiplatelet agents (Ticagrelol or Prasugrel).

The primary end point was the composite of cardiovascular death, ACS or ischemic stroke at 1 year (MACE). A major secondary end point was BARC major bleeding (types 3, 4, or 5).

Results and discussion

A total 155 cases were analyzed from January 2017 to December 2018, 89% were eligible to obtain for analysis. A primary end-point event occurred in 6 of 75 patients (8%) in the ticagrelor group and in 6 of 64 patients (10.93%) in the prasugrel group. Among secondary end point events there are 3 cases of major bleeding in ticagrelol group (2.25%) and 3 cases in prasugrel group (1.92%).

Withdrawal of a treatment were occurred in 17 (10.97%) cases

It`s a preliminary data from ongoing data collecting.

Conclusion

The number of MACE cases is relatively high despite treatment of potent antiplatelet agents and GBM treatments. Compared to the randomized studies PLATO and TRITON occurrence of MACE was higher.

Preliminary data demonstrate statistically insignificant (P value = 0.553) differences between the two drugs in clinical outcomes after one year. There were no differences in bleeding occurrence