BACKGROUND: Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by using optical coherence tomography (OCT) immediately after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS: We performed OCT immediately after PCI in 108 ACS patients pretreated with either prasugrel (n=51) or clopidogrel (n=57). OCT detected thrombus/plaque protrusion in all stented segments. RESULTS: Although stent volume (190.4±119.1mm3 vs. 189.4±95.8mm3, p=0.961), mean stent area (6.9±2.9mm2 vs. 7.1±2.0mm2, p=0.772), and minimum stent area (5.6±2.7mm2 vs. 5.4±1.7mm2, p=0.554) were not different between the two groups, in-stent thrombus/plaque protrusion volume (1.8±2.9mm3 vs. 4.5±5.3mm3, p=0.002), mean in-stent thrombus/plaque protrusion area (0.1±0.1mm2 vs. 0.2±0.2mm2, p=0.005), and maximum in-stent thrombus/plaque protrusion area (0.5±0.7mm2 vs. 0.8±0.6mm2, p=0.007) were significantly smaller in the prasugrel group compared with the clopidogrel group. CONCLUSIONS: Pretreatment with prasugrel was associated with significantly reduced in-stent thrombus/plaque protrusion immediately after PCI for ACS compared with that with clopidogrel.
BACKGROUND:Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by using optical coherence tomography (OCT) immediately after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS: We performed OCT immediately after PCI in 108 ACS patients pretreated with either prasugrel (n=51) or clopidogrel (n=57). OCT detected thrombus/plaque protrusion in all stented segments. RESULTS: Although stent volume (190.4±119.1mm3 vs. 189.4±95.8mm3, p=0.961), mean stent area (6.9±2.9mm2 vs. 7.1±2.0mm2, p=0.772), and minimum stent area (5.6±2.7mm2 vs. 5.4±1.7mm2, p=0.554) were not different between the two groups, in-stent thrombus/plaque protrusion volume (1.8±2.9mm3 vs. 4.5±5.3mm3, p=0.002), mean in-stent thrombus/plaque protrusion area (0.1±0.1mm2 vs. 0.2±0.2mm2, p=0.005), and maximum in-stent thrombus/plaque protrusion area (0.5±0.7mm2 vs. 0.8±0.6mm2, p=0.007) were significantly smaller in the prasugrel group compared with the clopidogrel group. CONCLUSIONS: Pretreatment with prasugrel was associated with significantly reduced in-stent thrombus/plaque protrusion immediately after PCI for ACS compared with that with clopidogrel.