Comparison of the degree of platelet aggregation inhibition with prasugrel versus clopidogrel and clinical outcomes in patients with unprotected left main disease treated with everolimus-eluting stents

Angela Migliorini, Renato Valenti, Guido Parodi, Rossella Marcucci, Rosanna Abbate, Nazario Carrabba, Gian Franco Gensini, David Antoniucci

Research output: Contribution to journalArticle

Abstract

The everolimus-eluting stent (EES) performs better than the first generation drug-eluting stent. Prasugrel compared with clopidogrel in acute coronary syndromes treated invasively is associated with improved clinical outcome and decreased risk of stent thrombosis. The aim of the study was to compare the clinical outcome and degree of platelet aggregation inhibition of patients treated with EES for unprotected left main disease (ULMD) and receiving clopidogrel or prasugrel. Patients receiving an EES for ULMD and with low residual platelet reactivity on clopidogrel or prasugrel treatment were included in the analysis. The primary end point of the study was the composite of cardiac mortality and myocardial infarction at 1 year. The secondary end point was the degree of platelet aggregation inhibition as assessed by light transmittance aggregometry. From January 2009 to December 2011, 252 patients with low residual platelet reactivity on thienopyridine treatment were treated with EES for ULMD. Of these, 104 patients received clopidogrel and 148 received prasugrel. The primary end point rate was lower in the prasugrel group compared with clopidogrel group: 1.3% and 9.6%, respectively (p = 0.002). Residual platelet reactivity was less in the prasugrel group compared with clopidogrel group (adenosine diphosphate 10 μmol/L 37 ± 17% and 45 ± 15%, respectively, p

Original languageEnglish
Pages (from-to)1843-1848
Number of pages6
JournalThe American Journal of Cardiology
Volume112
Issue number12
DOIs
Publication statusPublished - Dec 15 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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