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AHA Trial Signals Higher One-Year Events With Ticagrelor Than Prasugrel in Diabetic Stent Patients

Investigators urged caution given the open-label design with peer-reviewed, longer-term results pending.

Overview

  • Preliminary one-year results from the randomized TUXEDO-2 trial were presented November 10 at the American Heart Association Scientific Sessions in New Orleans.
  • The primary composite outcome of heart attack, stroke, major bleeding, or death occurred in 16.57% of patients on ticagrelor versus 14.23% on prasugrel.
  • Individual events were numerically higher with ticagrelor: nonfatal heart attack 5.96% vs 5.21%, major bleeding 8.41% vs 7.14%, and death 5.03% vs 3.67%.
  • Subgroup analyses showed greater harm with ticagrelor in patients with diabetes duration under five years (HR 1.63; 95% CI 1.10–2.42) and in those at high bleeding risk (HR 1.61; 95% CI 1.02–2.53).
  • The 1,800-participant trial enrolled across 66 sites in India from 2020 to 2024, used an open-label design without adherence monitoring, and will follow patients for roughly five years.