title: Randomized comparison of ticagrelor versus prasugrel in patients with acute coronary syndrome and planned invasive strategy--design and rationale of the iNtracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 5 trial.
abstract: In acute coronary syndromes (ACS), a dual antiplatelet regimen with an adenosine diphosphate (ADP) receptor antagonist plus aspirin has become the cornerstone of treatment. The third-generation thienopyridine prasugrel and the cyclopentyl-triazolo-pyrimidine ticagrelor provide a greater, more rapid and consistent platelet inhibition compared to their predecessor clopidogrel. Based on their advantages over clopidogrel in two landmark studies, both drugs received a class I recommendation for their use in ACS patients with and without ST segment elevation. Due to differences in ACS populations and conditions investigated, the relative merits of ticagrelor versus prasugrel in the treatment of ACS patients with planned invasive strategy cannot be reliably estimated from independent trials. To date, no direct head-to-head comparison of ticagrelor and prasugrel in terms of clinical outcome exists. The aim of this multicenter, randomized, open-label trial is to assess whether ticagrelor is superior to prasugrel in ACS patients with planned invasive strategy.
authors.affiliation: Deutsches Herzzentrum München, Technische Universität München, Munich, Germany, schulzs@dhm.mhn.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Dominick J
authors.initials: DJ
authors.lastname: Angiolillo
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.forename: Isabell
authors.initials: I
authors.lastname: Bernlochner
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.forename: Juliane
authors.initials: J
authors.lastname: Jaitner
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Katharina
authors.initials: K
authors.lastname: Mayer
authors.forename: Barbara
authors.initials: B
authors.lastname: von Merzljak
authors.forename: Tanja
authors.initials: T
authors.lastname: Morath
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Judith
authors.initials: J
authors.lastname: Ruf
authors.forename: Gisela
authors.initials: G
authors.lastname: Schömig
authors.forename: Helmut
authors.initials: H
authors.lastname: Schühlen
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D002985:Clinical Protocols; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005858:Germany; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000068799:Prasugrel Hydrochloride; D012107:Research Design; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000401:mortality; D013876:Thiophenes / Q000008:administration & dosage* / Q000009:adverse effects; D000077486:Ticagrelor; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D013876:Thiophenes; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine