Ticagrelor Adverse Events: Comparative Study Reveals Higher Rates
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Prasugrel Outperforms Ticagrelor in Diabetic patients Post-Stent Implantation: TUXEDO-2 Trial Findings
New Orleans,LA – November 10,2025 – A new study presented at the American Heart Association’s Scientific Sessions 2025 challenges conventional wisdom regarding antiplatelet therapy following percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with diabetes. The TUXEDO-2 trial reveals that prasugrel may be a superior choice to ticagrelor in preventing adverse cardiovascular events and bleeding complications in individuals with type 1 or type 2 diabetes. This finding is notable, as both drugs are commonly prescribed to prevent blood clots from forming in stents.
The Problem: Stent Thrombosis and the Need for Dual Antiplatelet Therapy
Coronary artery disease (CAD) remains a leading cause of death worldwide. PCI, often involving the placement of a drug-eluting stent, is a common and effective treatment for blocked arteries. However, stents aren’t a ‘cure-all’.A major risk following stent implantation is stent thrombosis – the formation of a blood clot within the stent – which can lead to heart attack or stroke.
to mitigate this risk, patients are prescribed dual antiplatelet therapy (DAPT), typically consisting of aspirin plus a P2Y12 inhibitor.Ticagrelor and prasugrel are two commonly used P2Y12 inhibitors. They work by preventing platelets from clumping together and forming clots. The choice between the two has historically been guided by factors like bleeding risk and individual patient characteristics, but frequently enough with the assumption of comparable efficacy.

(Image: Illustration of a drug-eluting stent in an artery)
TUXEDO-2: Study Design and population
The TUXEDO-2 study was a randomized, controlled clinical trial involving 1,800 adults in India diagnosed with type 1 or type 2 diabetes and multivessel disease (blockages in multiple coronary arteries). Participants underwent PCI with a drug-eluting stent. Crucially, all patients received one of two specific DES types: either the BioMatrix or the Onyx stent.
After the procedure, patients were randomly assigned to receive either:
* Prasugrel (10mg daily) plus aspirin
* Ticagrelor (90mg twice daily) plus aspirin
The primary outcome measured was a composite of heart attack, stroke, bleeding complications (defined by standardized criteria), and death, assessed after one year of treatment. Researchers also analyzed individual components of this composite outcome.
| Characteristic | Prasugrel Group (n=900) | Ticagrelor Group (n=900) |
|---|---|---|
| Mean Age (years) | 62.5 | 63.2 |
| Male (%) | 78.2 | 79.5 |
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