6/30/23, 2:21 AM TRITON-TIMI 38 Pathway Feedback Search Clinical Topics Home Studies TRITON TIMI 38 TRITON TIMI 38 Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Trial question What is the role of prasugrel in patients with moderate-to-high-risk acute coronary syndromes with scheduled PCI? Study design Multi-center Quadruple blinded RCT Population Characteristics of study participants 26.0% female N = 13608 74.0% male 13608 patients (3538 female, 10070 male) Inclusion criteria: patients with moderate-to-high-risk acute coronary syndromes with scheduled PCI Key exclusion criteria: an increased risk of bleeding, anemia, thrombocytopenia, a history of pathologic intracranial findings, or the use of any thienopyridine within 5 days before enrollment Interventions N=6813 prasugrel (a 60-mg loading dose and a 10-mg daily maintenance dose for 6-15 months) N=6795 clopidogrel (a 300-mg loading dose and a 75-mg daily maintenance dose for 6 to 15 months) https://web.pathway.md/studies/recVXfQlItCUPtqBr 1/2 6/30/23, 2:21 AM TRITON-TIMI 38 Pathway Primary outcome Death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke 12.1 % 12.1 9.9 9.1 % 6.0 % Significant decrease 3.0 % NNT = 45 0.0 % Prasugrel Clopidogrel Significant decrease in death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke (9.9% vs. 12.1%; HR 0.81, 95% CI 0.73 to 0.9) Secondary outcomes Significant decrease in nonfatal myocardial infarction (7.3% vs. 9.5%; HR 0.76, 95% CI 0.67 to 0.85) Safety outcomes No significant differences in nonfatal bleeding (1.1% vs. 0.9%, p=0.23). Significant differences in major bleeding (2.4% vs. 1.8%, p = 0.03; HR 1.32, 95% CI 1.03-1.68), life-threatening bleeding (1.4% vs. 0.9%, p = 0.01), including fatal bleeding (0.4% vs. 0.1%, p = 0.002). Conclusion In patients with moderate-to-high-risk acute coronary syndromes with scheduled PCI, prasugrel was superior to clopidogrel with respect to death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Reference Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007 Nov 15;357(20):2001-15. Open reference URL https://web.pathway.md/studies/recVXfQlItCUPtqBr 2/2