- 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.
- 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 were assessed.
- Funding: Daiichi Sankyo Incorporated; Eli Lilly and Company.
- Statistically significant differences in 30‐mo event rates were observed between peak troponin categories (<1×ULN, 6.2%; 1 to <3×ULN, 9.6%; 3 to <5×ULN, 10.8%; ≥5×ULN, 12.8%; P for all<.05).
- No significant interactions were observed between peak troponin ratio and study treatment for any of the ischaemic outcomes after adjustment for confounding factors (P for all outcomes>.05).
- Troponin assays were not standardized.
- Post-hoc analysis.