Abstract
Pharmacologic augmentation of treatment for atherosclerosis and acute coronary syndromes (ACS) has evolved over the years. The thienopyridine class of ADP P2Y12 inhibitors initially found success with ticlopidine, which is now of mainly historical interest. Clopidogrel, based on the success of major clinical trials such as CURE, CLARITY, COMMIT/CCS-2 and CREDO, has become the workhorse of this class of drugs. Prasugrel, a newer thienopyridine that requires only one metabolic step as opposed to the two metabolic steps for clopidogrel, was found to be clinically effective for the management of ACS and after percutaneous coronary interventions (PCI) in the PRINCIPLE-TIMI 44 and TRITON-TIMI 38 studies. Both clopidogrel and prasugrel now both carry Class 1B recommendations for the management of patients with an ACS and/or undergoing PCI, and this chapter summarizes the major clinical trials that have led to these recommendations.
Original language | English |
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Title of host publication | Therapeutic Advances in Thrombosis, Second Edition |
Pages | 26-46 |
Number of pages | 21 |
DOIs | |
State | Published - Oct 3 2012 |
Keywords
- Acute coronary syndrome
- Atherosclerosis
- Clopidogrel
- Percutaneous coronary intervention
- Prasugrel
- Ticlopidine
ASJC Scopus subject areas
- General Medicine