Intensity of antiplatelet therapy and percutaneous coronary intervention

Thienopyridine derivatives such as clopidogrel have been shown to reduce the incidence of death in patients undergoing percutaneous coronary intervention when used in conjunction with aspirin. Recently, a new thienopyridine, prasugrel, significantly reduced the primary endpoint of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke to 9.9% compared to 12.1% for clopidogrel. Prasugrel has been shown to be more efficacious than clopidigrel in reducing ischemic events and stent thrombosis, but does cause more life-threatening bleeding in patients undergoing percutaneous coronary intervention.