Clopidogrel more commonly prescribed than prasugrel, ticagrelor after PCI

Prasugrel and ticagrelor are common prescriptions for patients after undergoing percutaneous coronary intervention (PCI), reports a new study. Clopidogrel, however, sees the highest level of use.

Accessing the NCDR Practice Innovation and Clinical Excellence (PINNACLE) registry, researchers identified 26,710 patients (mean age, 74.5±7.0 years; 37.9 percent female) who had received PCI. A three-level variable identifying the second antiplatelet agent administered was taken as the study’s primary outcome.

Prasugrel was prescribed to 3,131 patients, corresponding to a rate of 12 percent. Ticagrelor, in comparison, was taken by 2,555 patients (10 percent). However, clopidogrel remained the most prevalent antiplatelet medication given, with a prescription rate of 79 percent (n=21,024).

Stable angina pectoris was more common among those on clopidogrel (22.1 percent) than in the prasugrel (17.8 percent) or ticagrelor (15.6 percent) groups. On the other hand, the relative frequencies of ticagrelor and prasugrel medications were higher in patients with prior myocardial infarction.

Patients who were at least 75 years of age, had hypertension, chronic heart failure, were smokers, and those with prior peripheral arterial disease and stroke/transient ischaemic attacks were significantly more likely to be prescribed clopidogrel rather than the other two agents.

In contrast, a history of myocardial infarction appeared to increase the likelihood of being prescribed ticagrelor or prasugrel.

Body mass index (BMI) is known to increase platelet activity and may promote the use of stronger antiplatelet agents, the researchers explained. However, it has shown no impact on the likelihood of stent thrombosis. Future studies are needed to determine the role that BMI may play in the prescription patterns of these medications.