Which antiplatelet is indicated for PCI only?
Aspirin, the most widely used antiplatelet agent, is effective, safe, and inexpensive and is recommended for all patients undergoing PCI.
When do you use prasugrel over clopidogrel?
The 2016 American College of Cardiology/American Heart Association Dual Antiplatelet Therapy update recommends prasugrel over clopidogrel (class IIa recommendations) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) except for those who are at high risk for bleeding (such as …
Which is better Plavix or Effient?
A previous trial of more than 13,000 ACS patients who were about to receive stents found that Effient was about 20 percent more effective than Plavix in preventing death, heart attacks and stroke. However, Effient also resulted in more cases of fatal bleeding.
What is the incremental cost effectiveness ratio of prasugrel?
Thus, compared with clopidogrel, prasugrel was an economically dominant treatment strategy. If a hypothetical generic cost for clopidogrel of $1/d is used, the incremental net cost with prasugrel was $996 per patient, yielding an incremental cost-effectiveness ratio of $9727 per life-year gained.
When do you use clopidogrel vs ticagrelor?
Importance Guidelines currently recommend ticagrelor over clopidogrel for patients with acute coronary syndrome (ACS) based on randomized clinical trial data in which ticagrelor reduced major adverse coronary events (MACE) vs clopidogrel but increased bleeding and dyspnea.
Why is heparin given during PCI?
Anticoagulants such as unfractionated heparin or bivalirudin are used at the time of PCI in order to reduce the risk of thrombotic complications. Unfractionated heparin is the anticoagulant used most commonly in support of PCI.
Is prasugrel and clopidogrel the same?
Prasugrel is a novel thienopyridine antiplatelet agent recently approved for the treatment of patients with ACS undergoing PCI. Prasugrel provides greater and more consistent platelet inhibition than clopidogrel due to earlier and more extensive formation of its active metabolite.
When should you not use prasugrel?
Prasugrel should also be avoided with concomitant use of medications that increase bleeding risk (i.e. warfarin) and should be used with caution in patients with low body weight (less than 60 kg).
Is prasugrel better than Plavix?
Are clopidogrel and ticagrelor the same?
A meta-analysis that pooled more than 10 clinical studies showed that ticagrelor and clopidogrel were similar in efficacy and safety. There were no significant differences found between the two drugs. Those taking ticagrelor were found to experience more shortness of breath compared to clopidogrel.
Which is best clopidogrel or aspirin?
The trial reported that long term administration of clopidogrel had better efficacy than aspirin for reducing a composite vascular events of ischemic stroke, acute myocardial infarction (AMI), or vascular death among all groups of patients with atherosclerotic vascular diseases.
Do you give heparin before PCI?
Percutaneous coronary intervention (PCI) improves outcomes in patients with acute myocardial infarction (MI) and is used to improve symptoms in patients with stable angina. Anticoagulants such as unfractionated heparin or bivalirudin are used at the time of PCI in order to reduce the risk of thrombotic complications.
Which is better for patients prasugrel or clopidogrel?
In diabetics, prasugrel was associated with a lower adjusted risk of 90-day death compared with clopidogrel. Use of prasugrel vs clopidogrel and outcomes in patients with and without diabetes mellitus presenting with acute coronary syndrome undergoing percutaneous coronary intervention
How does clopidogrel work as an antiplatelet?
Clopidogrel is a pro-drug which is converted to its active drug moiety by CYP450 2C19 isoenzyme. Certain patients who carry genetic alleles or are taking medications that inhibit this 2C19 isoenzyme may experience a diminished antiplatelet effect from clopidogrel.
Is there an increase in bleeding with prasugrel?
There was an increase in the rate of life-threatening bleeding with prasugrel, including a significant increase in fatal major hemorrhage. Bleeding episodes, including major or life-threatening hemorrhage, were more frequent in the prasugrel group than in the clopidogrel group, both near the time of PCI and after PCI.
What are the safety end points for prasugrel?
The primary efficacy end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The key safety end point was major bleeding.