Table 1.
Age-specific data in main randomized studies about standard DAPT.
| Study | ACS Population (%) | PCI Rate (%) | Elderly Patients (%) | Groups | Follow-Up (m) |
Main Results |
|---|---|---|---|---|---|---|
| CURE [29] | NSTE-ACS (100%) | 21.2% | >65 y (49.4%) |
Clopidogrel vs. placebo |
12 | Clopidogrel reduced the rate of ischemic events, but with an increase in major bleedings compared with placebo. |
| TRITON-TIMI 38 [33] | NSTE-ACS (74%), STEMI (26%) | 99% | ≥75 y (13%) | Prasugrel (10 mg) vs. clopidogrel |
15 | Prasugrel significantly reduced the rate of ischemic events, but with an increased risk of major bleeding. Elderly patients had no net clinical benefit from prasugrel. |
| ELDERLY ACS2 [34] | NSTE-ACS (58.8%), STEMI (41.2%) |
99.3% | ≥75 y (100%) | Prasugrel (5 mg) vs. clopidogrel |
12 | No significant difference in the composite of ischemic and bleeding events between the two groups. |
| ISAR-REACT 5 [35,36] | NSTE-ACS (58.9%), STEMI (41.1%) | 84% | ≥75 y or low body weight (27.5%) | Prasugrel (5 mg) vs. ticagrelor |
12 | Prasugrel reduced the rate of ischemic events with no significant difference in major bleedings compared with ticagrelor. In elderly or low-body-weight patients, prasugrel reduced the risk of major bleedings with similar efficacy in terms of ischemic events compared with ticagrelor. |
| PLATO [37] | NSTE-ACS (60.6%), STEMI (38.5%) | 65.6% | ≥75 y (15.5%) | Ticagrelor vs. clopidogrel |
12 | Ticagrelor, as compared with clopidogrel, reduced the rate of ischemic events without an increase in the rate of overall major bleeding, but with an increase in the rate of non-CABG-related bleeding. These findings were not found to depend on age. |
| POPular AGE [38] | NSTE-ACS (100%) | 47.3% | ≥70 y (100%); ≥75 y (65%) |
Ticagrelor vs. clopidogrel |
12 | Clopidogrel reduced the rate of major and minor bleeding events without an increase in the combined endpoint of ischemic and bleeding events compared with ticagrelor. |
m = months, y = years, CABG = coronary artery bypass graft.