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ISAR REACT Study

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La Dra. Silvia Valbuena López repasa los resultados del estudio con ticagrelor y prasugrel en pacientes con síndrome coronario agudo, presentado en ESC Congress 2019.

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ISAR REACT Study

  1. 1. Silvia Valbuena López ISAR-REACT 5: TICAGRELOR VS PRASUGREL IN ACUTE CORONARY SYNDROMES NEJM. September 1, 2019. DOI: 10.1056/NEJMoa1908973
  2. 2. Silvia Valbuena LópezISAR-REACT 5 BACKGROUND • PLATO and TRITON-TIMI trials showed superiority of ticagrelor and prasugrel compared to clopidogrel in ACS • No trial to date has directly evaluated both drugs NON-STEMI STEMI
  3. 3. Silvia Valbuena LópezISAR-REACT 5 AIM  head to head comparison of a Ticagrelor vs Prasugrel-based strategy in ACS patients with/without ST-elevation HYPOTHESIS  Ticagrelor will be superior to Prasugrel (expected incidence of primary endpoint 10% vs 12,9%, RRR 22,5%)
  4. 4. Silvia Valbuena LópezISAR-REACT 5 TRIAL DESIGN • Investigator-led (DZHK München) • Randomized, multicenter, open-label • Outcomes asigned by blinded evaluator • Inclusion  ACS with planned invasive strategy • Endpoints: - Primary endpoint  death + MI + stroke (12 months) - Secondary endpoint  death, MI, stroke, stent thrombosis (definite or probable) - Safety endpoint  Bleeding BARC 3-5 • Ticagrelor and Prasugrel doses as per guidelines  Prasugrel administered after angiography in N-STEMI
  5. 5. Silvia Valbuena LópezISAR-REACT 5 STUDY FLOW
  6. 6. Silvia Valbuena LópezISAR-REACT 5 BASELINE CHARACTERISTICS
  7. 7. Silvia Valbuena LópezISAR-REACT 5 RESULTS
  8. 8. Silvia Valbuena LópezISAR-REACT 5 RESULTS
  9. 9. Silvia Valbuena LópezISAR-REACT 5 RESULTS
  10. 10. Silvia Valbuena LópezISAR-REACT 5 RESULTS
  11. 11. Silvia Valbuena LópezISAR-REACT 5 LIMITATIONS • Open-label • Comparison of 2 drugs and 2 treatment strategies
  12. 12. Silvia Valbuena LópezISAR-REACT 5 CONCLUSIONS In patients with ACS with or without ST-elevation, Prasugrel compared to Ticagrelor significantly reduced the composite endpoint of death, MI or stroke

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