title: Prevalence of contraindications and conditions for precaution for prasugrel administration in a real world acute coronary syndrome population.
abstract: The prevalence of prasugrel contraindications and specific conditions requiring precaution for its use in a real world acute coronary syndrome (ACS) population is not known. We performed a prospective descriptive study in 1016 consecutive moderate to high risk ACS patients. In 646 patients (63.6%) subjected to percutaneous coronary intervention, analysis of absolute contraindications (history of stroke/transient ischemic attack or active bleeding), relative contraindications and specific conditions (age ≥ 75 years and/or weight < 60 kg) for prasugrel theoretical administration was performed. In 242 (37.5%) patients there was at least one absolute or relative contraindication or specific condition requiring attention for its use. Overall, 23.1% of patients in our cohort had a prior stroke/transient ischemic attack and/or specific condition to be considered for prasugrel administration. Specifically, the prevalence of stroke/TIA was 3.6%, the prevalence of patients ≥75 years 20% and the prevalence of patients weighing <60 kg 2.2%. Among patients ≥75 years old, 63 (9.8%) had diabetes mellitus or previous myocardial infarction, consisting a high risk subgroup that might benefit from prasugrel administration. In a real world ACS population a relatively high proportion of patients have a potential contraindication for prasugrel administration or necessitate special attention for its use.
authors.affiliation: Department of Cardiology, Patras University Hospital, Rio, Patras, Greece. dalex@med.upatras.gr
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Alexopoulos
authors.forename: Ioanna
authors.initials: I
authors.lastname: Xanthopoulou
authors.forename: Panagiota
authors.initials: P
authors.lastname: Mylona
authors.forename: Angelos
authors.initials: A
authors.lastname: Perperis
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Panagiotou
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Dimitropoulos
authors.forename: Grigorios
authors.initials: G
authors.lastname: Tsigkas
authors.forename: George
authors.initials: G
authors.lastname: Hahalis
authors.forename: Periklis
authors.initials: P
authors.lastname: Davlouros
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D000068799:Prasugrel Hydrochloride; D015995:Prevalence; D011446:Prospective Studies; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D010879:Piperazines; D058921:Purinergic P2Y Receptor Antagonists; D013876:Thiophenes; D000068799:Prasugrel Hydrochloride