{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:02:28Z","timestamp":1780668148042,"version":"3.54.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Data on the comparative efficacy and safety of ticagrelor versus prasugrel in patients with ST-segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention are limited. We assessed the efficacy and safety of ticagrelor versus prasugrel in a head-to-head comparison in patients with ST-segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>In this prespecified subgroup analysis, we included 1653 patients with ST-segment\u2013elevation myocardial infarction randomized to receive ticagrelor or prasugrel in the setting of the ISAR REACT-5 trial (Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 5). The primary end point was the incidence of death, myocardial infarction, or stroke at 1 year after randomization. The secondary end point was the incidence of bleeding defined as BARC (Bleeding Academic Research Consortium) type 3 to 5 bleeding at 1 year after randomization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The primary end point occurred in 83 patients (10.1%) in the ticagrelor group and in 64 patients (7.9%) in the prasugrel group (hazard ratio, 1.31 [95% CI, 0.95\u20131.82];\n              <jats:italic>P<\/jats:italic>\n              =0.10). One-year incidence of all-cause death (4.9% versus 4.7%;\n              <jats:italic>P<\/jats:italic>\n              =0.83), stroke (1.3% versus 1.0%;\n              <jats:italic>P<\/jats:italic>\n              =0.46), and definite stent thrombosis (1.8% versus 1.0%;\n              <jats:italic>P<\/jats:italic>\n              =0.15) did not differ significantly in patients assigned to ticagrelor or prasugrel. One-year incidence of myocardial infarction (5.3% versus 2.8%; hazard ratio, 1.95 [95% CI, 1.18\u20133.23];\n              <jats:italic>P<\/jats:italic>\n              =0.010) was higher with ticagrelor than with prasugrel. BARC type 3 to 5 bleeding occurred in 46 patients (6.1%) in the ticagrelor group and in 39 patients (5.1%) in the prasugrel group (hazard ratio, 1.22 [95% CI, 0.80\u20131.87];\n              <jats:italic>P<\/jats:italic>\n              =0.36).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In patients with ST-segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention, there was no significant difference in the primary end point between prasugrel and ticagrelor. Ticagrelor was associated with a significant increase in the risk for recurrent myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01944800.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.120.050244","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:00:11Z","timestamp":1603962011000},"page":"2329-2337","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Ticagrelor or Prasugrel in Patients With ST-Segment\u2013Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"142","clinical-trial-number":[{"clinical-trial-number":"nct01944800","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Alp","family":"Aytekin","sequence":"first","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gjin","family":"Ndrepepa","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz-Josef","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology II, University Heart Center Freiburg\u00b7Bad Krozingen, Germany (F.J.N., C.V., D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Menichelli","sequence":"additional","affiliation":[{"name":"Ospedale Fabrizio Spaziani, Cardiology, Frosinone, Italy (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Mayer","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"W\u00f6hrle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical Campus Lake Constance, Friedrichshafen, Germany (J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabell","family":"Bernlochner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik Innere Medizin I (Kardiologie, Angiologie, Pneumologie), Klinikum Rechts der Isar, Munich, Germany (I.B., I.W., K.L.L)."},{"name":"German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany (I.B., D.S., K.L.L., H.B.S., M.J., H.S., S.S., A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shqipdona","family":"Lahu","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Richardt","sequence":"additional","affiliation":[{"name":"Heart Center Bad Segeberg, Germany (G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Witzenbichler","sequence":"additional","affiliation":[{"name":"Helios Amper-Klinikum Dachau, Cardiology &amp; Pneumology, Germany (B.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Sibbing","sequence":"additional","affiliation":[{"name":"Klinik der Universit\u00e4t M\u00fcnchen, Ludwig\u2013Maximilians\u2013University, Cardiology, Munich, Germany (D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8668-4313","authenticated-orcid":true,"given":"Salvatore","family":"Cassese","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8451-2131","authenticated-orcid":true,"given":"Dominick J.","family":"Angiolillo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville (D.J.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Valina","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology II, University Heart Center Freiburg\u00b7Bad Krozingen, Germany (F.J.N., C.V., D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Kufner","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5499-7024","authenticated-orcid":true,"given":"Christoph","family":"Liebetrau","sequence":"additional","affiliation":[{"name":"Heart Center, Campus Kerckhoff of Justus-Liebig-University, Giessen, Germany (C.L.,C.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian W.","family":"Hamm","sequence":"additional","affiliation":[{"name":"Heart Center, Campus Kerckhoff of Justus-Liebig-University, Giessen, Germany (C.L.,C.W.H.)."},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany (C.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0728-2819","authenticated-orcid":true,"given":"Erion","family":"Xhepa","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6765-6352","authenticated-orcid":true,"given":"Alexander","family":"Hapfelmeier","sequence":"additional","affiliation":[{"name":"Technical University of Munich, School of Medicine, Institute of General Practice and Health Services 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K.L.L)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Joner","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."},{"name":"German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany (I.B., D.S., K.L.L., H.B.S., M.J., H.S., S.S., A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-7121","authenticated-orcid":true,"given":"Dietmar","family":"Trenk","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology II, University Heart Center Freiburg\u00b7Bad Krozingen, Germany (F.J.N., C.V., D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Fusaro","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., S.C., S.K., E.X., H.B.S., M.J., M.F., H.S., S.S., A.K)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Ludwig","family":"Laugwitz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik Innere Medizin I (Kardiologie, Angiologie, Pneumologie), Klinikum Rechts der Isar, Munich, Germany (I.B., I.W., K.L.L)."},{"name":"German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany (I.B., D.S., K.L.L., H.B.S., M.J., H.S., S.S., A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-3001","authenticated-orcid":true,"given":"Heribert","family":"Schunkert","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Cardiology and Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (A.A., G.N., K.M., S.L., 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