Comparative Effectiveness of Prasugrel Versus Clopidogrel in Patients with Impaired Renal Function: A Clinical Review

Highlights

• Prasugrel achieves faster and more significant early platelet aggregation reduction than clopidogrel in patients with eGFR < 45 mL/min/1.73 m².
• The differential efficacy of antiplatelet agents emerges primarily within the first five days of treatment initiation.
• Both prasugrel and clopidogrel maintain a favorable safety profile with respect to bleeding risk across renal function strata.
• Renal impairment influences early pharmacodynamic response to P2Y12 inhibitors, emphasizing tailored antiplatelet therapy.

Background