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Prasugrel is an analogue of clopidogrel that has more-consistent platelet-inhibitory activity and faster onset of action. In a previous trial, prasugrel was more effective than clopidogrel for preventing adverse coronary events (JW Oncol Hematol Dec 4 2007). However, use of prasugrel was associated with higher bleeding rates; therefore, researchers have questioned whether the agent benefits patients with ST-segment-elevation myocardial infarction (STEMI) who undergo percutaneous coronary interventions (PCIs).
To address these concerns, investigators performed an industry-supported, multinational, randomized trial involving 3534 patients with STEMI who were assigned to receive either clopidogrel (300 mg loading dose and then 75 mg daily) or p…