“Patients presenting with acute coronary syndromes, such as myocardial infarction, are treated with dual antiplatelet therapy to prevent recurrent ischaemia and mortality.” The enclosed informative article is from the Australian Prescriber and provides valuable information on these two drugs!

“Ticagrelor and prasugrel are antiplatelet drugs that are alternatives to clopidogrel in acute coronary syndrome. Their advantages include reduced rates of ischaemia and stent thrombosis.

The risk of major bleeding is likely to be higher with prasugrel compared to clopidogrel. Intracranial haemorrhage appears to be slightly more common with ticagrelor than with clopidogrel, and it can also cause dyspnoea and ventricular pauses early in treatment.

Current guidelines published by the Cardiac Society of Australia and New Zealand (CSANZ)4 recommend that either ticagrelor or prasugrel should be considered as alternative drugs to clopidogrel in patients presenting with ST-elevation myocardial infarction who are at high risk of recurrent ischaemic events, such as those with:

  1. diabetes mellitus
  2. stent thrombosis
  3. recurrent ischaemic events despite clopidogrel therapy
  4. a high burden of disease on coronary angiography.”
Antiplatelet drugs PDF