High Platelet Reactivity in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: Randomised Controlled Trial Comparing Prasugrel and Clopidogrel

PloS One
Tobias GeislerMiles Dalby

Abstract

Prasugrel is more effective than clopidogrel in reducing platelet aggregation in acute coronary syndromes. Data available on prasugrel reloading in clopidogrel treated patients with high residual platelet reactivity (HRPR) i.e. poor responders, is limited. To determine the effects of prasugrel loading on platelet function in patients on clopidogrel and high platelet reactivity undergoing percutaneous coronary intervention for acute coronary syndrome (ACS). Patients with ACS on clopidogrel who were scheduled for PCI found to have a platelet reactivity ≥40 AUC with the Multiplate Analyzer, i.e. "poor responders" were randomised to prasugrel (60 mg loading and 10 mg maintenance dose) or clopidogrel (600 mg reloading and 150 mg maintenance dose). The primary outcome measure was proportion of patients with platelet reactivity <40 AUC 4 hours after loading with study medication, and also at one hour (secondary outcome). 44 patients were enrolled and the study was terminated early as clopidogrel use decreased sharply due to introduction of newer P2Y12 inhibitors. At 4 hours after study medication 100% of patients treated with prasugrel compared to 91% of those treated with clopidogrel had platelet reactivity <40 AUC (p = 0.49), while ...Continue Reading

References

Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Mar 17, 2011·JAMA : the Journal of the American Medical Association·Matthew J PriceUNKNOWN GRAVITAS Investigators
Oct 20, 2011·Circulation. Cardiovascular Interventions·Guillaume ParéAdnan Kastrati
Nov 18, 2011·JAMA : the Journal of the American Medical Association·Jessica L MegaMarc S Sabatine
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Nov 6, 2012·The New England Journal of Medicine·Jean-Philippe ColletUNKNOWN ARCTIC Investigators
Nov 22, 2012·Circulation. Cardiovascular Interventions·Dimitrios AlexopoulosGeorge Hahalis
May 25, 2013·Thrombosis and Haemostasis·T GeislerM Schwab
Sep 3, 2013·The New England Journal of Medicine·Gilles MontalescotUNKNOWN ACCOAST Investigators
Oct 1, 2013·Journal of the American College of Cardiology·Udaya S TantryUNKNOWN Working Group on On-Treatment Platelet Reactivity
Jun 9, 2014·European Heart Journal·Thomas Pilgrim, Stephan Windecker

❮ Previous
Next ❯

Citations

Dec 9, 2016·Thrombosis and Haemostasis·Madhumita ChatterjeeMeinrad Gawaz
Mar 1, 2018·Current Treatment Options in Cardiovascular Medicine·Daniel R MangelsTaisei Kobayashi
May 12, 2020·Future Cardiology·Michael SpartalisVassilis Voudris
Jul 20, 2021·Journal of Cardiovascular Medicine·Monica VerdoiaUNKNOWN Novara Atherosclerosis Study Group (NAS)

❮ Previous
Next ❯

Clinical Trials Mentioned

NCT01339026
NCT01959451

Software Mentioned

APACS
APTOR
Sealed Envelope
Multiplate Analyzer

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.