Editorial
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World J Cardiol. Jun 26, 2010; 2(6): 131-134
Published online Jun 26, 2010. doi: 10.4330/wjc.v2.i6.131
Alternatives to clopidogrel for acute coronary syndromes: Prasugrel or ticagrelor?
Giuseppe Biondi-Zoccai, Marzia Lotrionte, Fiorenzo Gaita
Giuseppe Biondi-Zoccai, Marzia Lotrionte, Fiorenzo Gaita, Division of Cardiology, University of Turin, San Giovanni Battista “Molinette” Hospital, 10126 Turin, Italy; Unit for Heart Failure and Cardiac Rehabilitation, Catholic University, 00136 Rome, Italy
Author contributions: Biondi-Zoccai G conceived and drafted the manuscript; Lotrionte M and Gaita F provided critical comments to the manuscript and final approval.
Correspondence to: Dr. Giuseppe Biondi-Zoccai, Division of Cardiology, University of Turin, San Giovanni Battista “Molinette” Hospital, Corso Bramante 88-90, 10126 Turin, Italy. gbiondizoccai@gmail.com
Telephone: +39-11-6334195 Fax: +39-11-6967053
Received: May 24, 2010
Revised: June 1, 2010
Accepted: June 8, 2010
Published online: June 26, 2010
Abstract

Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular prostheses. However, its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new, more potent competitors, such as prasugrel and ticagrelor. But what is the actual body of evidence in support of clopidogrel? Is there any dark side of the moon? What is the role of prasugrel, which has already been approved in Europe and in the United States? And what will be the future role of ticagrelor, when approved for routine clinical practice? We hereby concisely summarize the scope of this clinical choice, providing arguments in favor and against each of the three antiplatelet agents: clopidogrel, prasugrel, and ticagrelor.

Keywords: Acute coronary syndrome, Clopidogrel, Prasugrel, Ticagrelor