Non‐ST‐segment elevation ACS: does choice of antiplatelet therapy affect outcomes across troponin categories?

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  • Linear relationship was observed between increasing peak troponin and 30-mo ischaemic events in patients with non‐ST‐segment elevation acute coronary syndromes (NSTEACS).
  • Prasugrel vs clopidogrel showed no significant benefit in outcomes according to peak troponin.

Why this matters

  • Relationship between levels of troponin and outcomes among patients with NSTEMI is well-established; this is not explored in medically managed patients.
  • Study evaluated the effects of prasugrel and clopidogrel on outcomes according to troponin status.

Study design

  • 6763 medically managed patients with NSTEACS were randomly assigned to prasugrel or clopidogrel.
  • Relationship between peak troponin/upper limit of normal (ULN) ratio within 48 h of the index ACS event and 30‐mo outcomes wer...