Prasugrel is superior to ticagrelor for reducing ischaemic events in patients with acute coronary syndrome and a planned invasive strategy. The late breaking results of the ISAR-REACT 5 trial are presented at ESC Congress 2019 and published in the New England Journal of Medicine. There was no increase in the rate of majorbleeding with prasugrel. We met at ESC 2019 principal investigator Stefanie Schüpke of the German Heart Centre Munich: “In this investigator-initiated, multicentre, randomised clinical trial of invasively treated acute coronary syndromepatients, prasugrel significantly reduced thecomposite rate of death, myocardial infarction, or stroke compared to ticagrelor with no rise in the rate of major bleeding”.