CLOPIDOGREL VERSUS PRASUGREL IN PATIENTS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTION

Objective: To compare short term clinical outcomes in patients on Clopidogrel and Prasugrel undergoing elective percutaneous coronary interventions. Methodology: This comparative study was conducted in Department of Cardiology department, Postgraduate Medical Institute Govt. Lady Reading Hospital Peshawar from 1st June 2012 to 31st March 2013. Patients undergoing elective PCI for significant lesions on coronary angiography of both genders having weight 60 Kg and baseline platelets aggregation 5 ohm. All patients were followed for 1 month. There is no short term clinical benefit of Prasugrel over Clopidogrel in elective percutaneous coronary intervention. as platelets aggregation. Results: A total of 148 patients were included in the study. Group A had 74 patients 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 aggregation was 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 in Prasugrel group which led to discontinuation of the drug while minor bleeding episodes in 7 (9.5%) patients. Conclusion: There was NSTEMI ACS in 3 (4.1%) patients and STEMI in 01 (1.35%) in Clopidogrel group while 2 STEMI patients in Prasugrel group. Number of deaths were 2 in prasugrel group and 1 in clopidogrel group Composite of death, major bleeding, stroke, ACS was 7 (9.5%) in Prasugrel group and 6 (8%) in Clopidogrel group (p=0.09).