Prasugrel: Newest Antiplatelet Agent and Its Emerging Role in Management of Acute Coronary Syndrome and Percutaneous Coronary Intervention

Abstract

Oral antiplatelet therapy has been very effective in reducing vascular events. Currently available oral antiplatelet agents are aspirin and the thienopyridine P2Y(12)-receptor antagonists. These agents are used frequently in combination among patients with coronary artery disease, and also following percutaneous coronary intervention to reduce major adverse cardiovascular events. Emergence of resistance to either aspirin or clopidogrel, or both the agents, is a major concern as antiplatelet resistance is likely to increase thrombotic events, thus resulting in a worse clinical outcome. Development of new agents has therefore become imperative. Prasugrel is the newest thienopyridine with the most robust clinical data, and appears to be superior to clopidogrel, the most extensively used agent besides aspirin in contemporary cardiovascular practice. Possible advantages of prasugrel over clopidogrel are its faster onset of action, reduced inter-patient variability, and more potent and persistent platelet inhibition. This article summarizes the available clinical data on prasugrel in the treatment of coronary artery disease.