Use of low-dose prasugrel vs. clopidogrel in elderly patients with high clinical and PCI complexity.
Claudio Montalto1; Gabriele Crimi1, ; Stefano Savonitto2; Stefano De Servi3;
1. Division of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy, Italy 2. Division of Cardiology, Ospedale Manzoni, Lecco, Italy 3. Department of Cardiology, IRCCS Multimedica, Milano, Italy
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Prasugrel was proven to be superior to clopidogrel in reducing ischemic events in the setting of acute coronary syndromes (ACS) but failed to improve outcomes in elderly patients at higher bleeding risk. Despite elderly patients often present with increased ischemic risk and a more potent P2Y12 inhibition was suggested to be preferable in terms of longer dual antiplatelet therapy (DAPT) duration[3,4] or of a potent drug use, evidence supporting the use of prasugrel in this specific subset are lacking. The aim of this paper was to evaluate the impact of high clinical and PCI complexity on the investigational treatment in elderly patients with ACS.