Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes.

Lahu, Shqipdona; Behnes, Michael; Ndrepepa, Gjin; Neumann, Franz-Josef; Sibbing, Dirk; Bernlochner, Isabell; Menichelli, Maurizio; Mayer, Katharina; Richardt, Gert; Gewalt, Senta; Angiolillo, Dominick J; Coughlan, John Joseph; Aytekin, Alp; Witzenbichler, Bernhard; Hochholzer, Willibald; Cassese, Salvatore; Kufner, Sebastian; Xhepa, Erion; Sager, Hendrik B; Joner, Michael; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Schüpke, Stefanie; Kastrati, Adnan; Akin, Ibrahim

doi:10.1016/j.rec.2021.11.007

journal article

Title:: Body mass index and efficacy and safety of ticagrelor versus prasugrel in patients with acute coronary syndromes.
Document type:: Article; Clinical Study; Journal Article
Author(s):: Lahu, Shqipdona; Behnes, Michael; Ndrepepa, Gjin; Neumann, Franz-Josef; Sibbing, Dirk; Bernlochner, Isabell; Menichelli, Maurizio; Mayer, Katharina; Richardt, Gert; Gewalt, Senta; Angiolillo, Dominick J; Coughlan, John Joseph; Aytekin, Alp; Witzenbichler, Bernhard; Hochholzer, Willibald; Cassese, Salvatore; Kufner, Sebastian; Xhepa, Erion; Sager, Hendrik B; Joner, Michael; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Schüpke, Stefanie; Kastrati, Adnan; Akin, Ibrahim
Abstract:: INTRODUCTION AND OBJECTIVES: The efficacy and safety of ticagrelor vs prasugrel in patients with acute coronary syndromes (ACS) according to body mass index (BMI) remain unstudied. We assessed the efficacy and safety of ticagrelor vs prasugrel in patients with ACS according to BMI. METHODS: Patients (n=3987) were grouped into 3 categories: normal weight (BMI <25kg/m2; n=1084), overweight (BMI ≥ 25 to <30kg/m2; n=1890), and obesity (BMI ≥ 30kg/m2; n=1013). The primary efficacy endpoint was the 1 year incidence of all-cause death, myocardial infarction, or stroke. The secondary safety endpoint was the 1 year incidence of Bleeding Academic Research Consortium type 3 to 5 bleeding. RESULTS: The primary endpoint occurred in 63 patients assigned to ticagrelor and 39 patients assigned to prasugrel in the normal weight group (11.7% vs 7.5%; HR, 1.62; 95%CI, 1.09-2.42; P=.018), 78 patients assigned to ticagrelor and 58 patients assigned to prasugrel in the overweight group (8.3% vs 6.2%; HR, 1.36; 95%CI, 0.97-1.91; P=.076), and 43 patients assigned to ticagrelor and 37 patients assigned to prasugrel in the obesity group (8.6% vs 7.3%; HR, 1.18; 95%CI, 0.76-1.84; P=.451). The 1-year incidence of bleeding events did not differ between ticagrelor and prasugrel in patients with normal weight (6.5% vs 6.6%; P=.990), overweight (5.6% vs 5.0%; P=.566) or obesity (4.4% vs 2.8%; P=.219). There was no significant treatment arm-by-BMI interaction regarding the primary endpoint (Pint=.578) or secondary endpoint (Pint=.596). CONCLUSIONS: In patients with ACS, BMI did not significantly impact the treatment effect of ticagrelor vs prasugrel in terms of efficacy or safety. CLINICAL TRIAL REGISTRATION: NCT01944800.
Journal title abbreviation:: Rev Esp Cardiol (Engl Ed)
Year:: 2022
Journal volume:: 75
Journal issue:: 9
Pages contribution:: 747-755
Fulltext / DOI:: doi:10.1016/j.rec.2021.11.007
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34961732
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert); Klinik und Poliklinik für Innere Medizin I, Kardiologie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2022