Prasugrel is a novel platelet inhibitor currently under clinical development in cooperation with Eli Lilly and company for acute coronary syndromes.
   
  As published in the New England Journal of Medicine, the TRITON-TIMI 38 study of 13,608 patients with acute coronary syndromes compared prasugrel against clopidogrel, both in combination with aspirin, and found that, as a more potent anti-platelet agent, it reduced the rate of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke with prasugrel (12.1% for clopidogrel vs. 9.9% for prasugrel). These favorable results were obtained at the expense of increasing the rate of serious bleeding (1.4%, vs. 0.9% in the clopidogrel group) and fatal bleeding (0.4% vs. 0.1%).
   
  From the editorial in the NEJM, "In TRITON–TIMI 38, for each death from cardiovascular causes prevented by the use of prasugrel as compared with clopidogrel, approximately one additional episode of fatal bleeding was caused by prasugrel
   
  At present some trials have been halted by Eli Lilly.