Ia l Interventional Cardiologist, Fortis Hospital, Bangalore, India m Consultant, Department of Cardiology, Fortis Hospital, Noida, India n Associate Director, Department of Cardiology, Fortis Hospital, Shalimar Bagh, Delhi, India o Director, Division of Cardiology, Fortis Hospital, Amritsar, Indiab aarticle infoArticle history: Received 11 September 2014 Accepted 26 November 2014 Readily available online 17 December 2014 Keywords and phrases: Prasugrel Bleeding SafetyabstractBackground: Clopidogrel has been the only out there antiplatelet drug utilised in conjunction with aspirin in individuals of ACS. In current years 2 new antiplatelet drugs (Prasugrel and Ticagrelor) have turn out to be accessible. Prasugrel within the dose of 10 mg OD has been located to become additional efficacious but with enhanced threat of major bleeding. For this reason it has not gained widespread usage in ACS individuals undergoing PCI. You will discover no systematic information on the use of Prasugrel in Indian population. Approach: This is a potential, multicentric, hospital registry of 1000 sufferers with ACS undergoing PCI who had been administered Prasugrel. The principal safety endpoint of this study was significant and minor bleeding while the DDR1 Purity & Documentation efficacy endpoint would be the composite of CV death, nonfatal MI, nonfatal stroke as much as 30 days soon after PCI. Individuals with higher bleeding danger were excluded. Outcomes: Most sufferers (91 ) received loading dose of Prasugrel in addition to the maintenance dose acquiring in accordance with the defined protocol. Individuals had been followed as much as 30 days post Corresponding author. Fortis Escorts Heart Institute, Okhla Road, New Delhi 110025 India. Tel.: 1 9811150518, 1 11 47135000; fax: 1 11 26825013. E-mail addresses: upendra.kaul@fortishealthcare, kaul.upendra@gmail (U. Kaul). http://dx.doi.org/10.1016/j.ihj.2014.11.001 0019-4832/Copyright 2014, Cardiological Society of India. All rights reserved.i n d i a n h e a r t j o u r n a l 6 6 ( two 0 1 four ) 5 9 eight e6 0procedure. Principal efficacy finish point was reached in three sufferers only with two of them dying on account of attainable stent thrombosis and also the third requiring revascularization of the target vessel for stent thrombosis. A single major and 19 minor bleeding complications were recorded, with access internet site bleeding in 0.7 non-access website bleeding in 1.two from the subjects. Conclusion: Prasugrel was discovered to become powerful not S1PR5 manufacturer connected having a higher incidence of bleeding inside the high danger ACS patients when those at a high bleeding danger had been excluded. Copyright 2014, Cardiological Society of India. All rights reserved.1.Background2.two.ExclusionsDual antiplatelet therapy with aspirin and clopidogrel has been established to be efficacious in the therapy of acute coronary syndrome with PCI. Even so several sufferers continue to have recurrent atherothrombotic events on this therapy regardless of these positive effects. A lot more over delayed onset of action and modest antiplatelet effect with considerable interpatient variability has led for the improvement of newer antiplatelet drugs. Prasugrel, a prodrug, requires to become converted to its active metabolite just before binding towards the platelet P2Y12 receptor to possess its antiplatelet effect. Its efficacy has been effectively established in both phase two and phase three trials testing Prasugrel as when compared with common dose clopidogrel in patients undergoing PCI for ACS. Final results revealed good trends towards reduced ischaemic events i.e. substantially significantly less nonfatal MI significantly reduced price of stent thrombosis in the adhere to up period. These positive aspects have been restricted by a lot more complications.