Prasugrel in Clinical Practice

Abstract

The new drug is the latest addition to a class of agents that inhibit the platelet adenosine diphosphate (ADP) receptor, preventing initial platelet activation and consequent platelet aggregation -- a mechanism that has represented a major advance in the treatment of atherothrombotic diseases.1 Indeed, the use of the thienopyridine ticlopidine in combination with aspirin to inhibit platelet aggregation facilitated the widespread use of coronary-artery stenting. Because of the potential for serious side effects such as neutropenia, ticlopidine was quickly eclipsed by clopidogrel, which had better hematologic safety and fewer gastrointestinal side effects.