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The role of prasugrel in the management of acute coronary syndromes: a systematic review.

Publication ,  Journal Article
Spartalis, M; Tzatzaki, E; Spartalis, E; Damaskos, C; Athanasiou, A; Moris, D; Politou, M
Published in: European review for medical and pharmacological sciences
October 2017

Dual antiplatelet therapy (DAPT) is the treatment of choice in the medical management of patients with acute coronary syndrome (ACS). The combination of aspirin and a P2Y12 inhibitor in patients who receive a coronary stent reduces the rate of stent thrombosis and the rates of major adverse cardiovascular events. However, patients with acute coronary syndrome remain at risk of recurrent cardiovascular events despite the advance of medical therapy. The limitations of clopidogrel with variable antiplatelet effects and delayed onset of action are well established and lead to the development of newer P2Y12 inhibitors. Prasugrel is a selective adenosine diphosphate (ADP) receptor antagonist indicated for use in patients with ACS. Prasugrel provides greater inhibition of platelet aggregation than clopidogrel and has a rapid onset of action. We have conducted a systematic review to retrieve current evidence regarding the role of prasugrel in the management of ACS. Evidence comparing prasugrel, clopidogrel, and ticagrelor remain scant.A complete literature survey was performed using PubMed database search to gather available information regarding management of acute coronary syndromes and prasugrel. An explorative comparison of the safety and efficacy of prasugrel, clopidogrel, and ticagrelor was also conducted.Prasugrel and ticagrelor are more efficacious than clopidogrel in reducing the occurrence of non-fatal myocardial infarction, stroke, or cardiovascular (CV) death but they have also an increased risk of major bleeding in comparison to clopidogrel.Prasugrel and ticagrelor are today the recommended first-line agents in patients with ACS. The estimation of which drug is superior over the other cannot be reliably established from the current trials.

Duke Scholars

Published In

European review for medical and pharmacological sciences

EISSN

2284-0729

ISSN

1128-3602

Publication Date

October 2017

Volume

21

Issue

20

Start / End Page

4733 / 4743

Related Subject Headings

  • Ticlopidine
  • Thrombosis
  • Prasugrel Hydrochloride
  • Platelet Aggregation Inhibitors
  • Humans
  • Hemorrhage
  • Gastroenterology & Hepatology
  • Clopidogrel
  • Aspirin
  • Acute Coronary Syndrome
 

Citation

APA
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ICMJE
MLA
NLM
Spartalis, M., Tzatzaki, E., Spartalis, E., Damaskos, C., Athanasiou, A., Moris, D., & Politou, M. (2017). The role of prasugrel in the management of acute coronary syndromes: a systematic review. European Review for Medical and Pharmacological Sciences, 21(20), 4733–4743.
Spartalis, M., E. Tzatzaki, E. Spartalis, C. Damaskos, A. Athanasiou, D. Moris, and M. Politou. “The role of prasugrel in the management of acute coronary syndromes: a systematic review.European Review for Medical and Pharmacological Sciences 21, no. 20 (October 2017): 4733–43.
Spartalis M, Tzatzaki E, Spartalis E, Damaskos C, Athanasiou A, Moris D, et al. The role of prasugrel in the management of acute coronary syndromes: a systematic review. European review for medical and pharmacological sciences. 2017 Oct;21(20):4733–43.
Spartalis, M., et al. “The role of prasugrel in the management of acute coronary syndromes: a systematic review.European Review for Medical and Pharmacological Sciences, vol. 21, no. 20, Oct. 2017, pp. 4733–43.
Spartalis M, Tzatzaki E, Spartalis E, Damaskos C, Athanasiou A, Moris D, Politou M. The role of prasugrel in the management of acute coronary syndromes: a systematic review. European review for medical and pharmacological sciences. 2017 Oct;21(20):4733–4743.

Published In

European review for medical and pharmacological sciences

EISSN

2284-0729

ISSN

1128-3602

Publication Date

October 2017

Volume

21

Issue

20

Start / End Page

4733 / 4743

Related Subject Headings

  • Ticlopidine
  • Thrombosis
  • Prasugrel Hydrochloride
  • Platelet Aggregation Inhibitors
  • Humans
  • Hemorrhage
  • Gastroenterology & Hepatology
  • Clopidogrel
  • Aspirin
  • Acute Coronary Syndrome