Trial results favor prasugrel over ticagrelor after coronary stenting
Prasugrel reduced major cardiovascular events to the same extent as ticagrelor but with lower major bleeding after coronary stenting in patients with acute coronary syndromes, according to results from the SWITCH SWEDEHEART trial presented in a Hot Line session at ESC Congress 2026 and published simultaneously in the New England Journal of Medicine.
The SWITCH SWEDEHEART trial, presented at ESC Congress 2026, revealed that prasugrel and ticagrelor policies resulted in comparable one-year rates of death, myocardial infarction, or stroke in patients with acute coronary syndromes undergoing percutaneous coronary intervention (PCI). Prasugrel demonstrated a trend towards lower major bleeding and lower costs.
The trial, a policy-level randomized study within a national registry, evaluated the impact of two treatments on a real-world patient population at a fraction of the cost of a conventional trial, potentially serving as a model for clinical evidence generation in cardiology and other health care areas.
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