Evidence map›Paper›PMID 31915997›Full record

Observational studyClinical research in cardiology : official journal of the German Cardiac Society2020

Prasugrel use and clinical outcomes by age among patients undergoing PCI for acute coronary syndrome: from the PROMETHEUS study.

Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Kamilia Moalem, Annapoorna S Kini, Sunil V Rao, William Weintraub, Timothy D Henry, Birgit Vogel and 14 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Treatment of elderly patients with non-ST-elevation myocardial infarction: the nationwide POPular age registry.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 14 institutions in 3 countries.

Jaya ChandrasekharInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Usman BaberInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Samantha SartoriInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Melissa AquinoInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Kamilia MoalemInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Annapoorna S KiniMount Sinai Hospital, New York, NY, USA.
Sunil V RaoDuke University, Durham, NC, USA.
William WeintraubMedStar Washington Hospital Center, Washington, DC, USA.
Timothy D HenryCedars-Sinai Heart Institute, Los Angeles, CA, USA.
Birgit VogelInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Zhen GeInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Joseph B MuhlesteinIntermountain Heart Institute, Salt-Lake City, UT, USA.
Sandra WeissChristiana Care Health System, Newark, DE, USA.
Craig StraussMinneapolis Heart Institute, Minneapolis, MN, USA.
Catalin TomaUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Anthony DeFrancoAurora Cardiovascular Services, Milwaukee, WI, USA.
Bimmer E ClaessenInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Stuart KellerEli Lilly and Company, Indianapolis, IN, USA.
Brian A BakerDaiichi Sankyo, Inc, Parsippany, NJ, USA.
Mark B EffronEli Lilly and Company, Indianapolis, IN, USA.
Stuart PocockLondon School of Hygiene and Tropical Medicine, London, UK.
George DangasInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
Samir KapadiaCleveland Clinic, Cleveland, OH, USA.
Roxana MehranInterventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA. Roxana.mehran@mountsinai.org.
Icahn School of Medicine at Mount Sinai · USEli Lilly (United States) · USAmsterdam Neuroscience · NLAurora Health Care · USChristiana Care Health System · USCleveland Clinic · USDaiichi Sankyo (United States) · USDuke University · USIntermountain Medical Center · USLondon School of Hygiene & Tropical Medicine · GBMedStar Washington Hospital Center · USMinneapolis Heart Institute Foundation · USMount Sinai Hospital · USUniversity of Pittsburgh Medical Center · US

Funding

Daiichi-Sankyo NAEli Lilly and Company NA
6 · The paper itself

Abstract

backgroundPrasugrel is a potent thienopyridine that may be preferentially used in younger patients with lower bleeding risk.

objectiveWe compared prasugrel use and outcomes by age from the PROMETHEUS study. We also assessed age-related trends in treatment effects with prasugrel versus clopidogrel.

methodsPROMETHEUS was a multicenter acute coronary syndrome (ACS) percutaneous coronary intervention (PCI) registry. We compared patients in age tertiles (T1 < 60 years, T2 60-70 years, T3 > 70 years). Major adverse cardiac events (MACE) were a composite of death, myocardial infarction, stroke or unplanned revascularization. Data were adjusted using multivariable Cox regression for age-related risks and propensity score stratification for thienopyridine effects.

resultsThe study included 19,914 patients: 7045 (35.0%) in T1, 6489 (33.0%) in T2 and 6380 (32.0%) in T3. Prasugrel use decreased from T1 to T3 (29.2% vs. 23.5% vs. 7.5%, p < 0.001). Crude 1-year MACE rates were highest in T3 (17.4% vs. 16.8% vs. 22.7%, p < 0.001), but adjusted risk was similar between the groups (p-trend 0.52). Conversely, crude incidence (2.8% vs. 3.8% vs. 6.9%, p < 0.001) and adjusted bleeding risk were highest in T3 (HR 1.24, 95% CI 0.99-1.55 in T2; HR 1.83, 95% CI 1.46-2.30 in T3; p-trend < 0.001; reference = T1). Treatment effects with prasugrel versus clopidogrel did not demonstrate age-related trends for MACE (p-trend = 0.91) or bleeding (p-trend = 0.28).

conclusionsAge is a strong determinant of clinical risk as well as prasugrel prescription in ACS PCI with much lower use among older patients. Prasugrel did not have a differential treatment effect by age for MACE or bleeding. Frequency of prasugrel use and age-related temporal risks of all-cause death and bleeding after ACS PCI.

Indexed as

Percutaneous Coronary InterventionAcute Coronary SyndromeAgedCoronary AngiographyElectrocardiographyFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPlatelet Aggregation InhibitorsPostoperative ComplicationsPrasugrel HydrochloridePreoperative CareProspective StudiesPlatelet Aggregation InhibitorsPrasugrel HydrochlorideAcute coronary syndromeAge-related outcomesPercutaneous coronary interventionPrasugrel versus clopidogrel

Identifiers

PMID31915997
OpenAlexW2998765553

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.