Prasugrel versus clopidogrel in patients with acute coronary syndromes

Stephen D. Wiviott, Eugene Braunwald, Carolyn H. McCabe, Gilles Montalescot, Witold Ruzyllo, Shmuel Gottlieb, Franz Joseph Neumann, Diego Ardissino, Stefano De Servi, Sabina A. Murphy, Jeffrey Riesmeyer, Govinda Weerakkody, C. Michael Gibson, Elliott M. Antman

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Dual-antiplatelet therapy with aspirin and a thienopyridine is a cornerstone of treatment to prevent thrombotic complications of acute coronary syndromes and percutaneous coronary intervention. METHODS: To compare prasugrel, a new thienopyridine, with clopidogrel, we randomly assigned 13,608 patients with moderate-to-high-risk acute coronary syndromes with scheduled percutaneous coronary intervention to receive prasugrel (a 60-mg loading dose and a 10-mg daily maintenance dose) or clopidogrel (a 300-mg loading dose and a 75-mg daily maintenance dose), for 6 to 15 months. The primary efficacy end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The key safety end point was major bleeding. RESULTS: The primary efficacy end point occurred in 12.1% of patients receiving clopidogrel and 9.9% of patients receiving prasugrel (hazard ratio for prasugrel vs. clopidogrel, 0.81; 95% confidence interval [CI], 0.73 to 0.90; P

Original languageEnglish
Pages (from-to)2001-2015
Number of pages15
JournalNew England Journal of Medicine
Issue number20
Publication statusPublished - Nov 15 2007

ASJC Scopus subject areas

  • Medicine(all)


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