Prasugrel vs Ticagrelor: Diabetes & Stent Outcomes
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Prasugrel Shows Advantage Over Ticagrelor in diabetic Patients with Stents
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New research presented at the American Heart Association’s Scientific Sessions 2025 suggests that prasugrel may be more effective then ticagrelor in preventing complications after stent placement in patients with Type 1 or Type 2 diabetes.
The TUXEDO-2 study, a randomized clinical trial involving 1,800 adults in India with Type 1 or Type 2 diabetes and multivessel disease, evaluated the effectiveness of prasugrel and ticagrelor when used in conjunction with aspirin after the implantation of a drug-eluting stent.
All patients received a drug-eluting stent – a stent coated with medication to reduce the risk of re-narrowing – following a percutaneous coronary intervention to clear a blocked artery.
Study Findings
researchers tracked the rate of stroke, heart attack, bleeding complications, and death after one year of treatment with each medication regimen.
| Outcome | Ticagrelor Group (%) | Prasugrel Group (%) |
|---|---|---|
| Heart Attack, stroke, Bleeding, or Death (Composite) | 16.57 | 14.23 |
| Non-Fatal Heart Attack | 5.96 | 5.21 |
| Major Bleeding | 8.41 | 7.14 |
| Death | 5.03 | 3.67 |
These results indicate a statistically important difference in outcomes between the two medications.
“Our findings indicate that prasugrel may potentially be the better choice for patients with Type 1 or Type 2 diabetes. We where surprised by the results because we hypothesized that ticagrelor should be as good or perhaps even better than prasugrel. it’s important to choose the right medicine,and at least from our data,we cannot say that ticagrelor and prasugrel are interchangeable.”
Sripal Bangalore, M.D., M.H.A., FAHA, lead study author, professor of medicine at NYU Grossman School of Medicine, new York City