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

• Published in: Clinical Medicine Insights. Cardiology 2016-01, Vol.2016 (10), p.149-155
• Main Authors: Hajsadeghi, Shokoufeh, Chitsazan, Mandana, Chitsazan, Mitra, Salehi, Negar, Amin, Ahmad, Bidokhti, Arash Amin, Babaali, Nima, Bordbar, Armin, Hejrati, Maral, Moghadami, Samar
• Format: Article
• Language: English
• Subjects: Angioplasty; Original Research
• ISSN: 1179-5468; 1179-5468
• DOI: 10.4137/CMC.S32804

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, respectively) 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 reduction 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.