Comparative Non-Randomised Observational Study of Prasugrel and Ticagrelor in Patients Undergoing Percutaneous Coronary Intervention

Abstract

Percutaneous Coronary Intervention (PCI) is the primary guideline-recommended treatment strategy for patients presenting with CAD, STEMI, NSTEMI, Unstable Angina. It is known that, the use of oral P2Y12 receptor antagonists (Prasugrel and Ticagrelor) in PCI patients could lead to improved outcomes compared with clopidogrel. This study has been designed for review and analysis of clinical safety and outcomes of these agents in patients undergoing PCI. Out of 100 patients (50 in Prasugrel group & 50 in Ticagrelor group) considered for the study, the incidence of stroke, stent thrombosis was comparable between the groups with P =0.044, P =0.041 respectively and was not comparable for MI (P=0.245). Single Death was reported. The results differed significantly for Palpitations/Arrhythmia(P=0.018), SOB(P=0.000), Dizziness(P=0.005), Creatinine levels(P=0.000), Fatigue(P=0.003), Headache(P=0.000) and did not differ significantly for Bleeding and Back pain in both the drug groups with P =1.000, P =0.438 respectively. Also, majority of the patients showed decreased platelet count in both the drug groups. Withdrawal parameters, like withdrawal due to cost(P=0.172) and withdrawal due to fear of side effects(P=1.000) when evaluated for both the drugs showed no significant difference. Outcomes associated with Prasugrel were not superior to outcomes associated with Ticagrelor when 30 days to 6 months follow up was done. The clinical safety, side effects and withdrawal parameters were comparable and the results showed no significant difference between these drug groups.
 Keywords: Percutaneous Coronary Intervention, Ticagrelor, Prasugrel, Dual Anti-Platelet therapy, Acute Coronary Syndrome, Coronary Artery Disease.