What is the preferred treatment strategy for prasugrel given in addition to aspirin for the prevention of thrombotic events post-PCI in an elderly patient with no contraindications?

The preferred treatment strategy for prasugrel in the context of an elderly patient with no contraindications emphasizes balancing antiplatelet efficacy with safety considerations, particularly regarding the risk of bleeding. In this case, option B presents a situation where a 62-year-old woman weighing 80 kg with chronic kidney disease is the correct answer.

In elderly patients, especially those with conditions like chronic kidney disease, the metabolism and clearance of medications can be affected, which may increase the risk of side effects. While prasugrel is beneficial in reducing thrombotic events post-PCI, the standard dosage for most patients is 60 mg loading dose followed by 10 mg maintenance; however, the risk of bleeding increases with age and renal impairment.

The rationale for selecting the higher dose for the 62-year-old woman despite her chronic kidney condition may be considered in the context of her overall clinical picture, particularly if her kidney function allows for adequate drug clearance. Chronic kidney disease does not automatically result in dose adjustment for prasugrel, especially if she has no contraindications and her renal function is assessed to be stable enough not to warrant a reduced dose.

In practice, dose adjustments in elderly patients are often based on a comprehensive assessment of individual risks versus benefits, and