prasugrel + aspirin

The dual antiplatelet therapy (DAPT) regimen consisting of prasugrel and aspirin is a pharmacological intervention used to prevent thrombotic complications in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Prasugrel is a third-generation thienopyridine that acts as a potent, irreversible antagonist of the platelet P2Y12 receptor, thereby inhibiting ADP-induced platelet aggregation. Aspirin (acetylsalicylic acid) provides complementary antiplatelet activity by irreversibly inhibiting cyclooxygenase-1 (COX-1), which prevents the synthesis of thromboxane A2, a key mediator of platelet activation. In the PREMIUM trial (Prasugrel Monotherapy Following Primary PCI for STEMI), an investigator-initiated Phase 4 study led by Kindai University, this 12-month DAPT regimen serves as the standard-of-care comparator against a strategy of prasugrel monotherapy. The trial specifically evaluates whether omitting aspirin after the initial procedure can reduce major bleeding events without increasing ischemic risk in East Asian patients receiving contemporary drug-eluting stents.

Other names

DAPTprasugrel plus aspirindual antiplatelet therapy