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The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Pretreatment with Prasugrel in Non–ST-Segment Elevation Acute Coronary Syndromes

Open access
Montalescot, Gilles, Bolognese, Leonardo, Dudek, Dariusz, Goldstein, Patrick, Hamm, Christian, Tanguay, Jean-Francois, ten Berg, Jurrien M., Miller, Debra L., Costigan, Timothy M., Goedicke, Jochen, Silvain, Johanne, Angioli, Paolo, Legutko, Jacek, Niethammer, Margit, Motovska, Zuzana, Jakubowski, Joseph A., Cayla, Guillaume, Visconti, Luigi Oltrona, Vicaut, Eric, Widimsky, Petr·2013·New England Journal of Medicine

Abstract

BACKGROUND: Although P2Y12 antagonists are effective in patients with non-ST-segment elevation (NSTE) acute coronary syndromes, the effect of the timing of administration--before or after coronary angiography--is not known. We evaluated the effect of administering the P2Y12 antagonist prasugrel at the time of diagnosis versus administering it after the coronary angiography if percutaneous coronary intervention (PCI) was indicated. METHODS: We enrolled 4033 patients with NSTE acute coronary syndromes and a positive troponin level who were scheduled to undergo coronary angiography within 2 to 48 hours after randomization. Patients were randomly assigned to receive prasugrel (a 30-mg loading dose) before the angiography (pretreatment group) or placebo (control group). When PCI was indicated, an additional 30 mg of prasugrel was given in the pretreatment group at the time of PCI and 60 mg of prasugrel was given in the control group. RESULTS: The rate of the primary efficacy end point, a composite of death from cardiovascular causes, myocardial infarction, stroke, urgent revascularization, or glycoprotein IIb/IIIa inhibitor rescue therapy (glycoprotein IIb/IIIa bailout) through day 7, did not differ significantly between the two groups (hazard ratio with pretreatment, 1.02; 95% confidence interval [CI], 0.84 to 1.25; P=0.81). The rate of the key safety end point of all Thrombolysis in Myocardial Infarction (TIMI) major bleeding episodes, whether related or not related to coronary-artery bypass grafting (CABG), through day 7 was increased with pretreatment (hazard ratio, 1.90; 95% CI, 1.19 to 3.02; P=0.006). The rates of TIMI major bleeding and life-threatening bleeding not related to CABG were increased by a factor of 3 and 6, respectively. Pretreatment did not reduce the rate of the primary outcome among patients undergoing PCI (69% of the patients) but increased the rate of TIMI major bleeding at 7 days. All the results were confirmed at 30 days and in prespecified subgroups. CONCLUSIONS: Among patients with NSTE acute coronary syndromes who were scheduled to undergo catheterization, pretreatment with prasugrel did not reduce the rate of major ischemic events up to 30 days but increased the rate of major bleeding complications. (Funded by Daiichi Sankyo and Eli Lilly; ACCOAST ClinicalTrials.gov number, NCT01015287.).

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Metadata

Authors
Montalescot, G., Bolognese, L., Dudek, D., Goldstein, P., Hamm, C., Tanguay, J.-F., ten Berg, J. M., Miller, D. L., Costigan, T. M., Goedicke, J., Silvain, J., Angioli, P., Legutko, J., Niethammer, M., Motovska, Z., Jakubowski, J. A., Cayla, G., Visconti, L. O., Vicaut, E., & Widimsky, P.
Venue
New England Journal of Medicine
Published
2013-09-12
Volume
369
Issue
11
Pages
999-1010
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2153107785
Cited by
657
References
32
FWCI
48.73
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Pretreatment with Prasugrel in Non–ST-Segment Elevation Acute Coronary Syndromes. https://app.cochat.ai/papers/10.1056/nejmoa1308075
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Montalescot, G., Bolognese, L., Dudek, D., Goldstein, P., Hamm, C., Tanguay, J.-F., ten Berg, J. M., Miller, D. L., Costigan, T. M., Goedicke, J., Silvain, J., Angioli, P., Legutko, J., Niethammer, M., Motovska, Z., Jakubowski, J. A., Cayla, G., Visconti, L. O., Vicaut, E., & Widimsky, P. (2013). Pretreatment with Prasugrel in Non–ST-Segment Elevation Acute Coronary Syndromes. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1308075

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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