Relative Efficacy and Safety of Prasugrel and Clopidogrel in Medically Managed Patients of High Risk Unstable Angina/Non-ST-Elevation Myocardial Infarction (UA/NSTEMI)
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 7
Abstract
Background: The patients of unstable angina / non-ST-elevation myocardial infarction (UA/NSTEMI) who are managed medically continue to have high risk of future adverse clinical outcomes and remain an understudied population of patients. The primary objective of this study was to compare the relative efficacy and safety of prasugrel and clopidogrel in medically managed patients of high risk UA/NSTEMI. Methods: In this open label, prospective randomized study, 100 consecutive patients of high risk UA/NSTEMI were studied under two groups of 50 each. In one group, prasugrel was used with 40 mg as loading dose & 10 mg as maintenance dose while in the second group, clopidogrel was used as 300 mg loading dose followed by 75 mg as maintenance dose for a study period of 1 month. The patients were observed for the primary and secondary efficacy end points during the hospital stay (0-5 days) and follow up at 30 days. Results: The patients in the prasugrel group had lower incidence of major adverse cardiac events (MACE) as compared to clopidogrel group both during hospital stay (6 versus 16, p ˂ 0.05) and total number of adverse cardiac events observed during the study period of 1 month (10 versus 19, p ˂ 0.05 ). Although statistically insignificant, due to small sample size of study population, prasugrel was demonstrated to have better efficacy in diabetic cohort of the patients. For safety concerns, no any episode of major bleeding was observed with either of the drugs and minor bleeding rate was comparable between the two groups. Conclusion: Prasugrel resulted in greater benefit in reducing the ischemic events and improving the net outcome of ACS (high risk UA/NSTEMI) population in comparison to the standard clopidogrel therapy.
Authors and Affiliations
Vikas Chaudhary
Keywords
Related Articles
- EP ID EP527726
- DOI -
- Views 68
- Downloads 0
Misdistributions of Iron-Folic Acid (IFA): a Major deterrent to combat Anemia in Pregnant Women
As per WHO 2012 guidelines a pregnant women should receive IFA as soon as possible during gestation enabling pregnant women to consume a total of 180 tablets (though many countries aim for 90 tablets). Since, Antenatal c...
Colonic Adenocarcinoma Presenting as Hemophagocytic Syndrome: A Case Report
Hemophagocytic syndrome is a rare and potentially fatal disorder characterised by pathological immune activation associated with primary familial disorder, genetic mutation or occurring as a sporadic condition. The later...
Various Clinical Presentations of Nystagmus: Case Series and Review of Literature
Introduction: Nystagmus is a rhythmic regular oscillation of the eyes. In this case series, we present four cases who presented to the emergency department different clinical complaints and had nystagmus on examination....
Study of Morphology and Histopathology of Ligature Marks in Asphyxial Deaths by Compression of Neck in Jodhpur Region, Rajasthan
Introduction: The ligature mark is vital piece of evidence in asphyxia deaths. There has been extensive study about external appearance of asphyxia deaths due to hanging and ligature strangulation but histopathological s...
Resident Doctors Education on Appropriate Utility of Blood Components
At Sher-I-Kashmir institute of medical sciences, Soura Srinagar Kashmirs we, analyzed 1109 transfusion episodes for different blood components for their rationale use. 713(64.2%) were appropriate and 386(35.7%) were inap...