In a nutshell
This paper compared prasugrel and clopidogrel in the treatment of patients with acute coronary syndrome. Results suggested that prasugrel could be potentially beneficial over the long term in patients with acute coronary syndrome.
Some background
Acute coronary syndrome refers to situations where blood supplying the heart is blocked. This includes heart attack and angina (chest pain). Prasugrel and clopidogrel are therapies that stop platelets (red blood cells) from sticking together (clotting). Compared to clopidogrel, prasugrel has been shown to be more potent and have less varied outcomes. The authors compared prasugrel and clopidogrel in patients without a previous stroke.
Methods & findings
7243 patients were analyzed. Patients were randomly assigned to receive prasugrel or clopidogrel. All patients received aspirin as well.
The rate of strokes was 1.1% over an average follow-up period of 17 months. Patients who had a stroke were more likely to be older, and have other illnesses.
Frequency of strokes overall was less common among patients receiving prasugrel than patients receiving clopidogrel but this difference was not significant. There was no difference between prasugrel and clopidogrel in the risk of ischemic stroke after 3 months of treatment. However, after 12 months, patients who received prasugrel had a significantly reduced risk of ischemic stroke compared to patients who received clopidogrel.
The bottom line
The authors concluded that a longer duration of more intense platelet inhibition with prasugrel could be associated with lower rates of stroke in patients with acute coronary syndrome.
The fine print
The rate of stroke was low, so the evidence for the results are not strong.
What’s next?
Talk to your doctor about treatment options to reduce your risk of stroke.
Published By :
Stroke
Date :
Feb 16, 2016
