Greater Clinical Benefit of More Intensive Oral Antiplatelet Therapy With Prasugrel in Patients With Diabetes Mellitus in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel hrombolysis in Myocardial Infarction 38

Topic: General Cardiology
Date Posted: 9/8/2008

Clinical Trial: No

Study Question: What is the effect of prasugrel compared with clopidogrel among subjects with diabetes mellitus (DM) in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel hrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38) trial?

Methods: The authors classified 13,608 subjects on the basis of pre-existing history of DM and further according to insulin use in the TRITON-TIMI 38 trial. Prespecified analyses of the primary (cardiovascular death, nonfatal MI, or nonfatal stroke) and key secondary endpoints, including net clinical benefit (death, nonfatal MI, nonfatal stroke, and nonfatal TIMI major bleeding) were compared by use of the log-rank test.

Results: A total of 3,146 subjects had a pre-existing history of DM, including 776 receiving insulin. The primary endpoint was reduced significantly with prasugrel among subjects withou