CLOPIDOGREL VERSUS PRASUGREL IN PATIENTS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To compare short term clinical outcomes in patients on Clopidogreland Prasugrel undergoing elective percutaneous coronary interventions.

Methodology: This comparative study was conducted in Department ofCardiology department, Postgraduate Medical Institute Govt. Lady ReadingHospital Peshawar from 1st June 2012 to 31st March 2013. Patients undergoingelective PCI for significant lesions on coronary angiography of both gendershaving weight 60 Kg and baseline platelets aggregation5 ohm. All patients were followed for 1 month.

Results: A total of 148 patients were included in the study. Group A had 74patients using Clopidogrel and group B contained 74 patients using Prasugrel.Group A had 55 (74.3%) males while group B had 56 (75.7%) males (p=0.85).Mean age was 54.9±11.2 years in group A and 57.7±8.7 years in group B (p=0.09). Mean percent difference between basal and follow up platelet aggregationwas 52.96±24.77 ohm in group A and 82.25±14.34 ohm in group B (p=0.001). At 01 month follow up 03 (4%) episodes of major bleeding occurred inPrasugrel group which led to discontinuation of the drug while minor bleedingepisodes in 7 (9.5%) patients. There was NSTEMI ACS in 3 (4.1%) patients andSTEMI in 01 (1.35%) in Clopidogrel group while 2 STEMI patients in Prasugrelgroup. Number of deaths were 2 in prasugrel group and 1 in clopidogrel groupComposite of death, major bleeding, stroke, ACS was 7 (9.5%) in Prasugrelgroup and 6 (8%) in Clopidogrel group (p=0.09).

Conclusion: There is no short term clinical benefit of Prasugrel over Clopidogrelin elective percutaneous coronary intervention.