Prasugrel 5 mg vs. Ticagrelor 60 mg in CHIP (E5TION)

Inclusion Criteria:

1. Age 19 and more; and
2. Subjects who scheduled for percutaneous coronary intervention(PCI) with Firehawk®drug-eluting stent
3. At least one of the following high-risk factors;

• Clinical factors: diabetes, chronic kidney disease (GFR < 60ml/min/1.73m2), LVdysfunction (LV EF < 45%), or troponin (+).
• Lesion- or procedure-related factors: left main PCI, chronic totalocclusion, bifurcation lesion requiring two-stent technique, severecalcification, in-stent restenosis, multi-vessel PCI (≥ 2 vessels requiringstent implantation), PCI for ≥ 3 lesions, ≥ 3 stents implanted, or totalstent length > 60 mm.
• High platelet reactivity: VerifyNow PRU ≥ 266.

Exclusion Criteria:

1. Cardiogenic shock at the index admission
2. Bleeding tendency, congenital or acquired
3. Active bleeding or high-risk for major bleeding (e.g. active peptic ulcer disease,gastrointestinal pathology with a high-risk for bleeding, malignancies with ahigh-risk for bleeding)
4. Need for chronic oral anticoagulation
5. History of intracranial hemorrhage
6. Intracranial neoplasm, AV fistula or aneurysm
7. Platelet counts < 100,000/mm3
8. Liver cirrhosis with ascites or coagulopathy
9. Dialysis-impending or -dependent renal failure
10. Pregnant and/or lactating women
11. Increased risk of bradycardia events (sick sinus, AV block grade II or III,bradycardia-induced syncope)
12. Concomitant oral or i.v. therapy with strong CYP3A inhibitors (e.g., ketoconazole,itraconazole, voriconazole, telithromycin, clarithromycin, nefazodone, ritonavir,saquinavir, nelfinavir, indinavir, atazanavir, grapefruit juice >1L/day), CYP3Asubstrates with narrow therapeutic indices (e.g., cyclosporine, quinidine), or strongCYP3A inducers (e.g., rifampin/ rifampicin, phenytoin, carbamazepine, dexamethason,phenobarbital) that cannot be safely discontinued
13. Concurrent medical condition with a life expectancy of less than 1 years