Prasugrel

The unequivocal importance of platelet inhibition for prevention of secondary occlusive vascular events in patients with coronary heart disease is well established. Yet the scientific debates on the preferred agents for platelet inhibition have reached new heights. Recent antiplatelet clinical trials, such as Aspirin and Clopidogrel Compared With Clopidogrel Alone After Recent Ischaemic Stroke or Transient Ischaemic Attack in High-Risk Patients (MATCH),1 Clopidogrel and Aspirin Versus Aspirin Alone for the Prevention of Atherothrombotic Events (CHARISMA),2 Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel (TRITON),3 and Platelet Inhibition and Patient Outcomes (PLATO),4 have raised concerns with regard to vascular antithrombotic efficacy in the investigated, more potent combination antiplatelet regimens, which at the same time increase the bleeding risks. In a different conceptual approach, researchers have attempted to link high-risk cohorts and worsened clinical outcomes to the degree of platelet inhibition by individual tailoring of antiplatelet therapy. However, trials, such as the Gauging Responsiveness With A VerifyNow Assay—Impact on Thrombosis And Safety (GRAVITAS),5 Testing Platelet Reactivity In Patients Undergoing Elective Stent Placement on Clopidogrel to Guide Alternative Therapy With Prasugrel (TRIGGER-PCI),6 Intravenous and Oral Administration of Elinogrel to Evaluate Tolerability and Efficacy in Nonurgent Percutaneous Coronary Intervention Patients (INNOVATE-PCI),7 Assessment by a Double …