Ticagrelor versus Prasugrel in acute coronary syndrome: sex-specific analysis from the RENAMI Registry.

Background The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS population. Methods Data from the multicentre REgistry of New Antiplatelets in patients with Myocardial Infarction for 4424 ACS patients who underwent PCI and were treated with ticagrelor or prasugrel between 2012 to 2016 were analysed. Mean follow-up was 17 ± 9 months. Results After propensity score matching, there was no significant difference in the occurrence of primary endpoint of net adverse cardiac events between the ticagrelor and prasugrel in men (HR: 0.94; 95% CI: 0.69-1.29; p=0.71), or women (HR: 1.17; 95% CI: 0.63-2.20; p=0.62; p interaction [sex] = 0.40). Similarly, no differences were found in the occurrence of any of the secondary endpoints (MACE, all cause death, reinfarction, stent thrombosis, BARC major bleeding and BARC any bleeding) between the two P2Y12 groups between men and women. Conclusions In this real-world ACS population, no relative difference in efficacy or safety outcomes were found between ticagrelor and prasugrel between sexes.