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Prasugrel Results in Higher Decrease in High-Sensitivity C-Reactive Protein Level in Patients Undergoing Percutaneous Coronary Intervention Comparing to Clopidogrel Publisher



Hajsadeghi S1 ; Chitsazan M2 ; Chitsazan M2 ; Salehi N3, 4, 5, 6 ; Amin A3, 5, 6 ; Bidokhti AA3, 5, 6 ; Babaali N3, 5, 6 ; Bordbar A3, 5, 6 ; Hejrati M7 ; Moghadami S7
Authors
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Authors Affiliations
  1. 1. Department of Cardiology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Michigan State University, Sparrow Health System, East Lansing, MI, United States
  5. 5. Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Tehran University of Medical Sciences, Tehran, Iran

Source: Clinical Medicine Insights: Cardiology Published:2016


Abstract

Objectives: A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). Methods: The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix®; loading dose and maintenance dose of 300 and 75 mg daily, respec-tively) and 40 patients in the second group received prasugrel (Effient®; loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks. The hs-CRP levels between baseline and 12th week were compared.Results: Of the 120 patients, 69 patients (57.5%) were male. Pretreatment hs-CRP level was statistically comparable in clopidogrel (median, 15.10 mg/dL; interquartile range [IQR], 9.62-23.75 mg/dL) and prasugrel groups (median, 18 mg/dL; IQR, 14.25-22 mg/dL; P = 0.06). Patients taking clopidogrel showed a significant reduction in hs-CRP level compared with the baseline values (P < 0.001). Prasugrel administration also resulted in a significant reduc-tion in hs-CRP level (P < 0.001). A significant 73% overall reduction in the hs-CRP level was seen with prasugrel compared with 39% overall reduction in hs-CRP level with clopidogrel (P = 0.002). Conclusion: Prasugrel seems to be superior to clopidogrel in the reduction of hs-CRP in patients undergoing PCI. © the authors, publisher and licensee Libertas Academica Limited.
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