Why the study?
Does prasugrel provide more potent platelet inhibition and less response variability compared to clopidogrel in patients undergoing stenting or with acute coronary syndromes?
Does prasugrel provide more potent platelet inhibition and less response variability compared to clopidogrel in patients undergoing stenting or with acute coronary syndromes?
Prasugrel is highlighted as a potent thienopyridine derivative that may overcome the response variability and non-responsiveness associated with clopidogrel.
Supports prasugrel evaluation in ACS and stenting; leaves open whether platelet effects improve clinical outcomes.
Clinical trials have demonstrated the superior clinical efficacy of dual antiplatelet therapy with a thienopyridine (a P2Y(12) receptor blocker) and aspirin (COX-1 inhibitor) in patients undergoing stenting as well as patients with acute coronary syndromes. However, clopidogrel treatment is associated with a wide response variability and non-responsiveness in selected patients. The latter phenomenon is linked to the occurrence of recurrent ischaemic events including stent thrombosis in the recent studies. Prasugrel is a new thienopyridine derivative that produces more potent platelet inhibition and a rapid onset of action that is associated with irreversible P2Y(12) receptor blockade. The latter properties of prasugrel may provide a superior alternative to clopidogrel, with less response variability and a decreased prevalence of non-responsiveness.
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Tantry et al. (2006) studied this question.
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