Application of prasugrel in coronary interventional therapy

Dual oral antiplatelet therapy, aspirin plus thienopyridine, has been permitted to be used in percutaneous coronary intervention (PCI) procedures. Clopidogrel is the thienopyridine of choice for dual antiplatelet therapy in patients treated with PCI. However, there are two deficiencies with clopidogrel: (1) clopidogrel's antiplatelet activity is delayed because the drug needs to be metabolized into its active form, and (2) variability in patient response to clopidogrel has been confirmed. To overcome these limitations of clopidogrel, a new generation of more potent inhibitors of P2Y12 receptors with a more rapid onset of action has been introduced for clinical evaluation. This article, a nonexhaustive review of the literature on prasugrel, a third-generation oral thienopyridine, summarizes the current knowledge about the benefits and risks of prasugrel and outlines the most prudent strategies for clinical use of this drug.