Accès ouvert déclaré 2025 article

Preventive Effects of Prasugrel on Cerebrovascular Events Following Percutaneous Coronary Intervention

Hisaki Makimoto, Yusuke Sasabuchi, Tomoyuki Kabutoya, Takahide Kohro, Hayato Yamana, Yusuke Oba, Yasushi Imai, Kazuomi Kario, Hisahiko Sato, Arihiro Kiyosue, Yoshiko Mizuno, Kotaro Nochioka, Masaaki Nakayama, Takamasa Iwai, Yoshihiro Miyamoto, Masanobu Ishii, Taishi Nakamura, Kenichi Tsujita, Naoyuki Akashi, Hideo Fujita, Hideo Yasunaga, Tetsuya Matoba, Ryozo Nagai, Kenichi Aizawa, Takayuki Fujiwara, Mitsuhiro Fukata, Kazutoshi Hirose, Masamichi Ito, Hiroshi Kadowaki, Shunsuke Katsuki, Yoshimasa Kawazoe, Risa Kishikawa, Takeshi Kitai, Satoshi Kodera, Shun Minatsuki, Koki Nakanishi, Yasuhiro Nakano, Naoki Nakashima, Teruo Noguchi, Kenichi Sakakura, Masataka Sato, Shinnosuke Sawano, Hayato Shimizu, Hiroki Shinohara, Katsura Soma, Yoko Sumita, Jun A. Takahashi, Norihiko Takeda, Kensuke Tsushima, Yoshinori Yamanouchi, Takanori Yamashita, Atsushi Yao, Satoshi Yasuda

2Citations signalées, ce qui n’est pas une note de qualité

11Institutions déclarées

2Pays d’affiliation déclarés

Rattachement africain : jp, us. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

BACKGROUND: Dual antiplatelet drug administration is recommended after percutaneous coronary intervention (PCI) stent placement. Although prasugrel, a newer P2Y12 inhibitor, reportedly suppresses cardiovascular events more effectively than the traditional agent clopidogrel, its preventive effects on cerebrovascular disorders remain a topic of ongoing debate. This study aimed to examine the cerebrovascular efficacy and safety of post-PCI prasugrel and clopidogrel using extensive real-world data in Japan. METHODS: Using the CLIDAS (Clinical Deep Data Accumulation System) database, 7412 post-PCI patients who received dual antiplatelet therapy between April 2013 and March 2019 were identified. The primary end point was defined as the incidence of any stroke, while secondary end points included individual ischemic and hemorrhagic cerebrovascular events. The incidence of cerebrovascular events was compared between the prasugrel (2.5–3.75 mg daily; n=2219) and clopidogrel (75 mg daily; n=5193) groups using propensity-score inverse probability of treatment weighting and Fine and Gray models to account for competing risks. RESULTS: Within 1 year after PCI, the prasugrel group had a significantly lower incidence of cerebrovascular events (subdistribution hazard ratio, 0.46 [95% CI, 0.24–0.91]; P =0.027) than the clopidogrel group. The subgroup analyses did not show significant differences in the incidence of ischemic (subdistribution hazard ratio, 0.54 [95% CI, 0.25–1.14]; P =0.11) and hemorrhagic cerebrovascular events (subdistribution hazard ratio, 0.30 [95% CI, 0.084–1.10]; P =0.070) between the use of prasugrel and clopidogrel. One-year health care costs between patients treated with prasugrel and those treated with clopidogrel showed no significant differences. CONCLUSIONS: Our data suggest that post-PCI prasugrel use was associated with lower cerebrovascular events compared with the use of clopidogrel in combination with aspirin. Further research is necessary to substantiate the potential of prasugrel in lowering cerebrovascular risks after post-PCI while upholding a satisfactory safety profile.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.

Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref: Preventive Effects of Prasugrel on Cerebrovascular Events Following Percutaneous Coronary Intervention
Date Crossref: 01/08/2025
Éditeur: Ovid Technologies (Wolters Kluwer Health)
Type: journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.

Où se fait cette recherche

Jichi Medical University H. Yamana) pays non établi dans la notice
Université ou école supérieure
The University of Tokyo Institute of Medical Science pays non établi dans la notice
Université ou école supérieure
Precision Research (United States) pays non établi dans la notice
Entreprise
University of Tokyo Hospital pays non établi dans la notice
Établissement de santé
Development Bank of Japan pays non établi dans la notice
Institution
Bank of Japan pays non établi dans la notice
Institution
Tohoku University Departments of Cardiovascular Medicine (K.N.) pays non établi dans la notice
Université ou école supérieure
National Cerebral and Cardiovascular Center pays non établi dans la notice
Établissement de santé
Kumamoto University pays non établi dans la notice
Université ou école supérieure
Jichi Medical University Saitama Medical Center pays non établi dans la notice
Établissement de santé
Kyushu University pays non établi dans la notice
Université ou école supérieure
Inc Precision pays non établi dans la notice
Entreprise

H. Yamana) — Jichi Medical University, Institute of Medical Science — The University of Tokyo et Precision Research (United States), avec 9 autres affiliations.

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Les sujets associés

Antiplatelet Therapy and Cardiovascular DiseasesAtrial Fibrillation Management and OutcomesAcute Ischemic Stroke Management

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