A COMPARATIVE EVALUATION OF THE SAFETY AND TOLERABILITY OF THE COMBINATION ASPIRIN AND PRASUGREL WITH ASPIRIN AND CLOPIDOGREL IN POST PCI PATIENTS

Background: The use of dual antiplatelet therapy with clopidogrel and aspirin has been recommended for patients undergoing stent implantation and for patients with acute coronary syndromes. Prasugrel has many advantages over clopidogrel. It has been shown to metabolize to its active metabolite with more pronounced inhibition of platelets when compared to clopidogrel. Also with prasugrel, the inter subject variability is found to be minimal.

Methodology: Seventy two patients aged ≥ 18 years who have undergone percutaneous coronary intervention (PCI) were enrolled in a 12 week, open-label, comparative (4-arm) prospective, randomized study. The treatment arms were divided into 2 groups (total 4 treatment arms) based on the body weight (< 60 kgs - aspirin 75 mg + prazugrel 5 mg – 1 tab per day or aspirin 75 mg + clopidogrel 75 mg 1 tab twice daily & > 60 kgs - aspirin 75 mg + prazurel 10 mg 1 tab per day or aspirin 150 + clopidogrel 75 mg 1 tab twice daily) by simple randomization.

Results: Analysis of the baseline and post 12 week Hb levels showed no statistical significance (p=0.9425 in <60 kgs arm, p=0.5697 in > 60 kgs arm in baseline, (p=0.5330 in < 60 kgs arm, p=0.8179 in > 60 kgs arm posttreatment) indicating that both the groups are similar.

Conclusion: The safety profile of prasugrel with aspirin (especially haemoglobin levels keeping in mind gastrointestinal bleeding) is similar to clopidogrel with aspirin.