Prasugrel and Glycoprotein IIb/IIIa Inhibition in Percutaneous Coronary Intervention

In an observational analysis of TRITON-TIMI 38 data, prasugrel outperformed clopidogrel in patients with ACS, whether or not they received GP IIb/IIIa inhibitors.

Prasugrel, recently approved by the FDA, is a thienopyridine that achieves greater platelet inhibition than clopidogrel does. In this subanalysis of the TRITON-TIMI 38 study in patients with acute coronary syndromes who underwent percutaneous coronary intervention, investigators compared the efficacy of the two drugs in 7414 patients who received a glycoprotein (GP) IIb/IIIa inhibitor and in 6194 who did not. Nearly all participants also received aspirin.

Compared with clopidogrel, prasugrel reduced the rate of the primary endpoint — cardiovascular death, MI, or stroke — at 30 days by 24% (8.5% vs. 6.5%) in GP IIb/IIIa-inhibitor recipients and by 22% (6.1% vs. 4.8%) in nonrecipients. In addition, prasugrel reduced stent thrombosis by more th…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI