Heart HealthPrasugrel Beats Ticagrelor and Clopidogrel After Heart Stenting
When cardiologists place a stent in a blocked coronary artery, patients must take a blood-thinning medication to prevent clotting. Three drugs compete for that role: clopidogrel, ticagrelor, and prasugrel. This large meta-analysis pooled 15 randomized trials involving nearly 49,000 patients to compare all three head-to-head. Prasugrel came out on top — cutting the risk of major cardiovascular events by 20% versus clopidogrel, driven by fewer heart attacks and a 52% reduction in stent thrombosis. Ticagrelor did not significantly reduce overall cardiovascular events versus clopidogrel and raised the risk of major bleeding, including a near-doubling of intracranial hemorrhage. Prasugrel also outperformed ticagrelor directly, with fewer heart attacks and stent clots. The authors conclude prasugrel offers the best balance of benefit and safety for PCI patients.
