A registry-based stepped-wedge randomised trial: seven Swedish regions switched their default P2Y12 inhibitor from ticagrelor to prasugrel at staggered dates, covering 17,095 consecutive ACS patients undergoing PCI. Death, MI or stroke at one year 11.1 versus 11.8 percent (adjusted OR 0.90, 95% CI 0.77 to 1.06); major bleeding 4.2 versus 4.4 percent (OR 0.80, 0.64 to 0.99). Presented by Elmir Omerovic in Hot Line 3, NEJM.
