Improving outcomes in patients undergoing percutaneous coronary intervention: role of prasugrel

Abstract

Dual oral antiplatelet therapy, aspirin plus thienopyridine, has permitted a rapid increase in the use of coronary intervention procedures. Clopidogrel is the thienopyridine of choice for dual antiplatelet therapy in patients treated with percutaneous coronary intervention. However, there are two issues with clopidogrel: (1) clopidogrel’s antiplatelet activity is delayed because the drug needs to be metabolized into its active form and (2) variability in patient response to clopidogrel has been demonstrated. To overcome these shortcomings of clopidogrel, new more potent inhibitors of P2Y12 receptors, which have a more rapid onset of action have been introduced for clinical evaluation. This article is a nonexhaustive review of the literature and concentrates on prasugrel, a third-generation, oral thienopyridine. The purpose is to summarize the current knowledge about the benefits and risks of prasugrel and to outline the most prudent strategies for the drug’s clinical use.

Keywords:

• P2Y12 receptors
• prasugrel
• oral thienopyridine
• dual oral antiplatelet therapy

Acknowledgements

This study was supported by the Charles University Prague Research Project number MSM0021620817 and by Research Project number MZ0VFN2005 Ministry of Health, Czech Republic.

Disclosure

The authors do not have any financial or personal relationships that could inappropriately influence (or bias) the authors’ decisions, work, or manuscript.