PMID- 22930115
OWN - NLM
STAT- MEDLINE
DCOM- 20130228
LR  - 20181202
IS  - 1573-7241 (Electronic)
IS  - 0920-3206 (Linking)
VI  - 26
IP  - 5
DP  - 2012 Oct
TI  - Prasugrel versus high dose clopidogrel to overcome early high on clopidogrel 
      platelet reactivity in patients with ST elevation myocardial infarction.
PG  - 393-400
LID - 10.1007/s10557-012-6407-z [doi]
AB  - OBJECTIVE: There is a paucity of data regarding the early effectiveness of the 
      proposed 600 mg clopidogrel loading dose (LD) on platelet reactivity (PR) in ST 
      elevation myocardial infarction (STEMI) patients. If high on-treatment platelet 
      reactivity (HTPR) is present, prasugrel reloading and subsequent maintenance dose 
      (MD), might offer faster and stronger platelet inhibition than high clopidogrel 
      MD. METHODS: In 93 STEMI patients treated by primary percutaneous coronary 
      intervention we assessed PR using the VerifyNow P2Y12 platelet function test, 2 h 
      following 600 mg LD of clopidogrel. All the 60 (64.5 %) patients exhibiting HTPR 
      (defined as PR >/= 235 P2Y12 reaction units), were randomized to 1 of 2 therapeutic 
      strategies: reloading with prasugrel 60 mg/10 mg MD or high (150 mg) clopidogrel 
      MD. RESULTS: The primary endpoint of PR at 24 h post randomization was lower in 
      the prasugrel compared to the clopidogrel group (51.3, 25.7-77.0 versus 242.4, 
      215.8-268.9 P2Y12 reaction units, least square estimates, 95 % confidence 
      intervals, p < 0.001). PR at 2 h and 5 days post randomization was lower in the 
      prasugrel compared to the clopidogrel group (117.2, 70.9-163.4 and 101.6, 
      70.1-133.2 least square mean difference, 95 % confidence intervals, p < 0.001 for 
      both). At all the time points of PR assessment, HTPR rates were lower in 
      prasugrel than in clopidogrel group. CONCLUSIONS: HTPR is commonly observed early 
      post 600 mg clopidogrel LD in STEMI patients. In this case, prasugrel 60 mg LD/10 
      mg MD provides faster and stronger platelet inhibition than a high clopidogrel MD 
      regimen.
FAU - Alexopoulos, D
AU  - Alexopoulos D
AD  - Department of Cardiology, Patras University Hospital, Rion, 26500, Patras, 
      Greece. dalex@med.upatras.gr
FAU - Theodoropoulos, K C
AU  - Theodoropoulos KC
FAU - Stavrou, E F
AU  - Stavrou EF
FAU - Xanthopoulou, I
AU  - Xanthopoulou I
FAU - Kassimis, G
AU  - Kassimis G
FAU - Tsigkas, G
AU  - Tsigkas G
FAU - Damelou, A
AU  - Damelou A
FAU - Davlouros, P
AU  - Davlouros P
FAU - Hahalis, G
AU  - Hahalis G
FAU - Athanassiadou, A
AU  - Athanassiadou A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Cardiovasc Drugs Ther
JT  - Cardiovascular drugs and therapy
JID - 8712220
RN  - 0 (Piperazines)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Purinergic P2Y Receptor Antagonists)
RN  - 0 (Thiophenes)
RN  - A74586SNO7 (Clopidogrel)
RN  - G89JQ59I13 (Prasugrel Hydrochloride)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
CIN - Cardiovasc Drugs Ther. 2012 Oct;26(5):365-6. PMID: 23007628
MH  - Aged
MH  - Blood Platelets/drug effects/physiology
MH  - Clopidogrel
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/physiopathology
MH  - Piperazines/*administration & dosage
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Prasugrel Hydrochloride
MH  - Purinergic P2Y Receptor Antagonists/*administration & dosage
MH  - Thiophenes/*administration & dosage
MH  - Ticlopidine/analogs & derivatives
EDAT- 2012/08/30 06:00
MHDA- 2013/03/01 06:00
CRDT- 2012/08/30 06:00
PHST- 2012/08/30 06:00 [entrez]
PHST- 2012/08/30 06:00 [pubmed]
PHST- 2013/03/01 06:00 [medline]
AID - 10.1007/s10557-012-6407-z [doi]
PST - ppublish
SO  - Cardiovasc Drugs Ther. 2012 Oct;26(5):393-400. doi: 10.1007/s10557-012-6407-z.