Prasugrel in Acute Coronary Syndrome Patients Undergoing PCI
Prasugrel (Effient), in combination with Aspirin, may be used as an alternative to Clopidogrel in patients presenting with ACS (acute coronary syndromes) who are likely to undergo PCI (percutaneous coronary intervention).
Although Prasugrel was associated with a reduction of major adverse cardiac events across a wide range of patients when compared to Clopidogrel in the Triton-TIMI 38 study (Ref 1), the greatest benefit was seen in the following subgroups (Ref 2):
- Patients undergoing immediate primary PCI.
- History of stent thrombosis on Clopidogrel
- Patients with diabetes mellitus.
Prasugrel dose
- 60 mg loading
- 10 mg od maintenance.
Prasugrel is contraindicated if:
- Age > 75 yrs.
- Weight < 60 kg.
- Previous TIA or stroke.
References
- N England J Med 2007; 357:2001-15. http://www.nejm.org/doi/full/10.1056/NEJMoa0706482
- http://www.nice.org.uk/nicemedia/live/12324/45849/45849.pdf
