1,2 This advice is based on the results of the TRITON-TIMI 38 trial3 and the PLATO trial
Furthermore, real-world studies of ACS patients have not confirmed the benefits of the newer P2Y 12 inhibitors over clopidogrel
In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily In patients with ACS (NSTE-ACS or STEMI) treated with coronary stent implantation who have tolerated DAPT without a bleeding complication and who are not at high bleeding risk (e
1, 2 This advice is based on the results of the TRITON-TIMI 38 trial 3 and the PLATO trial
Escalation from clopidogrel to prasugrel or ticagrelor in the early, particularly acute phase of treatment, should occur with the use of a 60- or 180-mg loading dose (LD), respectively
For PCI with chronic
Compared to clopidogrel, prasugrel’s scope of use is relatively limited
Background: Clinical trial data studies suggest superiority of prasugrel over clopidogrel in patients with diabetes
Furthermore, real-world studies
However, clopidogrel is known to exhibit delayed actions and induce highly variable responses
The
Despite several clinical guidelines recommending prasugrel or ticagrelor over clopidogrel in ACS patients RMs, and IMs
However, the POPular Genetics trial (Patient Outcome After Primary Percutaneous Coronary Intervention [PCI]) showed that in patients with primary PCI, a CYP2C19 genotype–guided strategy was associated with a lower bleeding risk without
50% of reviewers reported a positive effect, while 23% reported a negative effect
The study was designed to demonstrate superiority of prasugrel 5 mg over clopidogrel 75 mg
While prasugrel demonstrated benefit in patients scheduled for percutaneous intervention (PCI), benefits of ticagrelor were seen irrespective of the treatment strategy
It is given to patients before they have a heart procedure called percutaneous coronary intervention (PCI)
Event-free survival (recurrence of ACS or death) for all patients () and for patients aged ≤75 years () treated with clopidogrel, prasugrel, or ticagrelor
Adjusting for sex, age, their interaction, pre-existing medication, and calendar year as proxy for On the other hand, prasugrel use was associated with higher rates of major (2
7
Hypersensitivity reaction to clopidogrel (Plavix®) or ticlopidine (Ticlid®), history of or This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements
Clopidogrel is a thienopyridine prodrug, the active metabolite of which (CAM) inhibits
Oral route (Tablet) Prasugrel can cause significant and sometimes fatal bleeding
The antiplatelet effect of prasugrel lasts until the lifespan of platelets