The Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel (TRITON-TIMI 38) was a head-to-head trial to assess the efficacy and safety of the experimental antiplatelet agent prasugrel versus standard care with clopidogrel on top of aspirin.1 In addition to some ischemic protection at the expense of an overwhelming bleeding disadvantage, prasugrel-treated patients experienced a 3 times higher rate of colonic neoplasms than clopidogrel-treated patients, a difference that was significant. The follow-up time in TRITON was long enough (14.5 months average), and the sample size was large enough to detect cancer rate differences. Of interest, known gastrointestinal bleeding preceded the diagnosis of colonic neoplasms in only half of the patients.
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Victor L. Serebruany, MD, PhD
This article was originally published in the May 2009 issue of The American Journal of Medicine.
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