Observational studyBMC cardiovascular disorders2025
The efficacy and safety of prasugrel in acute coronary syndrome: a propensity-matched Korean cohort study focused on age and weight of patients.
Observational study in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02806102 (Cardiovascular Risk and Identification of Potential High-risk Population in Korean Patients With Acute Myocardial Infarction II), which is not on this map. Cited by 1 paper.
What it found
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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.
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.
Cardiovascular Risk and Identification of Potential High-risk Population in Korean Patients With Acute Myocardial Infarction II (COREA-AMI II)
Who cites it
1 citing paper in PubMed.
- Prasugrel: Reassessing Its Role in Contemporary Antiplatelet Therapy.Cardiovascular therapeutics · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe clinical benefits of prasugrel compared to clopidogrel in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are well established. However, significant safety concerns persist, particularly in elderly (≥ 75 years) or low-weight (< 60 kg) patients, even with reduced-dose prasugrel. We aimed to evaluate the comparative effectiveness and safety of prasugrel versus clopidogrel after PCI in Korean ACS patients, focusing on elderly or low-weight subgroup.
methodsWe performed post-hoc analysis of data from the EFF-K and COREA-AMI II registries, including 3,744 prasugrel- and 9,588 clopidogrel-treated patients post-PCI. Propensity score (PS) matching created 3,725 patients per treatment arm to compare 1-year primary effectiveness (major adverse cardiac and cerebrovascular events [MACCE]: all-cause death, myocardial infarction, stroke, stent thrombosis, and any revascularization) and safety (Thrombolysis in Myocardial Infarction [TIMI] major or minor bleeding) outcomes. Subgroup analyses focused on age and weight of patients.
resultsAmong PS-matched patients, including 18.5% in the elderly (age ≥ 75 years) or low-body-weight (< 60 kg) (ELB) subgroup, the 1-year incidence of MACCE was significantly lower in the prasugrel arm (3.0% vs. 8.3%, HR 0.39, 95% CI 0.32-0.49, P < .001), with comparable TIMI bleeding rates (2.8% vs. 3.2%, HR 0.91, 95% CI 0.70-1.19, P = .495). In the ELB subgroup, 50.8% received 5 mg prasugrel. Prasugrel use was associated with a lower risk of MACCE (4.4% vs. 8.6%, HR 0.56, 95% CI 0.36-0.86, P = .009) without a significantly increased risk of bleeding (3.6% vs. 5.8%, HR 0.66, 95% CI 0.40-1.10, P = .111).
conclusionsIn this Korean PS-matched ACS cohort, prasugrel, even at a reduced dose, was associated with superior effectiveness compared to clopidogrel without a significant increase in bleeding risk. These benefits were consistently observed in ELB patients. Our findings support the use of prasugrel in selected high-risk populations and offer guidance for clinical practice. REGISTRATION: EFF-K, Cris.nih.go.kr, Identifier: KCT0002356, registered June 13, 2017. COREA-AMI II, Clinicaltrials.gov, Identifier: NCT02806102, registered May 31, 2016.
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