The role of more intense, sustained platelet inhibition in modifying the risk of stroke after acute coronary syndrome (ACS) events is unclear. Prasugrel is a third-generation thienopyridine adenosine diphosphate P2Y12-receptor antagonist that has demonstrated more potency and less response variability than clopidogrel with regard to platelet inhibition. In the Targeted Platelet Inhibition to Cl...

Methods The TRITON–TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel–Thrombolysis in Myocardial Infarction 38) enrolled 13,608 patients with an acute coronary syndrome (ACS) and planned percutaneous coronary intervention (PCI), and randomized them to clopidogrel or prasugrel. Use of a statin or CCB was left to the discretion of the tre...

OBJECTIVE Primary objective of this study was to compare the efficacy of Prasugrel vs. Clopidogrel in the patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) by measuring inhibition of platelet aggregation after loading and maintenance dose of both the drugs. The patients were also assessed for safety of the drugs. METHODS This was a randomised, do...

In closely monitored randomized controlled trials, newer P2Y12 agents (ticagrelor and prasugrel) reduced cardiovascular outcomes compared to clopidogrel following percutaneous coronary intervention (PCI) in acute syndrome (ACS). However, the bleeding risk associated with use of these real-world practice is not well understood. This study aimed evaluate comparative safety each inhibitor on hospi...

The role of more intense, sustained platelet inhibition in modifying the risk of stroke after acute coronary syndrome (ACS) events is unclear. Prasugrel is a third-generation thienopyridine adenosine diphosphate P2Y12-receptor antagonist that has demonstrated more potency and less response variability than clopidogrel with regard to platelet inhibition. In the Targeted Platelet Inhibition to Cl...

BACKGROUND Intracoronary stenting can improve procedural success and reduce restenosis compared with balloon angioplasty in patients with acute coronary syndromes, but can also increase the rate of thrombotic complications including stent thrombosis. The TRITON-TIMI 38 trial has shown that prasugrel-a novel, potent thienopyridine-can reduce ischaemic events compared with standard clopidogrel th...

Dual antiplatelet treatment (DAPT) with aspirin and a P2Y12 receptor antagonist is essential for patients presenting with acute coronary syndrome (ACS) irrespective of their specific percutaneous coronary intervention (PCI). Clopidogrel (Bristol-Myers Squibb/Sanofi Pharmaceuticals, Bridgewater, NJ, USA), one of the most popular P2Y12 receptor antagonists of the past decade, has reduced the risk...

AIMS Whether prasugrel plus bivalirudin is a superior strategy to unfractionated heparin plus clopidogrel in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) has never been assessed in specifically designed randomized trials. METHODS AND RESULTS The Bavarian Reperfusion Alternatives Evaluation (BRAVE) 4 study is an in...

Mechanism-based inhibition of CYP2B6 in human liver microsomes by thienopyridine antiplatelet agents ticlopidine and clopidogrel and the thiolactone metabolites of those two agents plus that of prasugrel were investigated by determining the time- and concentration-dependent inhibition of the activity of bupropion hydroxylase as the typical CYP2B6 activity. By comparing the ratios of k(inact) (m...

Antiplatelet therapy is widely used with proven benefit for the prevention of further ischemic cardiac complications in patients with acute coronary syndrome. Treatment guidelines for acute coronary syndrome and percutaneous coronary intervention now recommend the use of oral antiplatelet agents including ticagrelor, prasugrel, or clopidogrel in combination with aspirin to comprise dual antipla...