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


CONCLUSIONS
Prasugrel seems to be superior to clopidogrel in the reduction of hs-CRP in patients undergoing PCI.
Associate Professor of Cardiology, Department of Cardiology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Shokoufeh
S
Hajsadeghi
Research Fellow, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mandana
M
Chitsazan
Research Fellow, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Mitra
M
Chitsazan
Michigan State University, Sparrow Health System, East Lansing, MI, USA.; Assistant Professor of Cardiology, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Negar
N
Salehi
Assistant Professor of Cardiology, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Ahmad
A
Amin
Cardiology Resident, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Arash Amin
AA
Bidokhti
Cardiology Resident, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Nima
N
Babaali
Cardiology Resident, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Armin
A
Bordbar
Research Fellow, Tehran University of Medical Sciences, Tehran, Iran.
Maral
M
Hejrati
Research Fellow, Tehran University of Medical Sciences, Tehran, Iran.
Samar
S
Moghadami
C-reactive protein; clopidogrel; coronary artery disease; percutaneous coronary intervention; prasugrel