PMID- 25904758
OWN - NLM
STAT- MEDLINE
DCOM- 20170323
LR  - 20181202
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 5
IP  - 3
DP  - 2016 Jun
TI  - In-hospital switching from clopidogrel to prasugrel following thrombolysis for 
      ST-elevation myocardial infarction: a 3-year single center experience.
PG  - 271-6
LID - 10.1177/2048872615584075 [doi]
AB  - BACKGROUND: Prasugrel has proved its superiority over clopidogrel for reducing 
      ischemic events among patients with ST elevation myocardial infarction (STEMI) 
      undergoing urgent percutaneous coronary intervention (PCI). Data on switching of 
      antiplatelet therapy in acute coronary syndrome patients in clinical practice are 
      very limited. Importantly, the safety of in-hospital switching from clopidogrel 
      to prasugrel following thrombolysis has not been addressed. METHODS: We reviewed 
      consecutive STEMI patients from February 2011 to April 2014 who were transferred 
      to a tertiary center after receiving thrombolysis and a loading dose of 
      clopidogrel in a non-PCI-capable center. If not contraindicated, these patients 
      were reloaded and treated with prasugrel. A control group, three times larger, 
      was selected from patients who underwent primary PCI and were initially treated 
      with prasugrel. In-hospital outcomes were examined. RESULTS: Cases (n=45, 13% 
      female, mean age 56 years) and controls (n=135, 11% female, mean age 54 years) 
      did not differ significantly with respect to MI location, left ventricular 
      systolic function, and extent of coronary artery disease. Mean time from 
      thrombolysis to prasugrel loading was 32+/-19 hours. No significant differences 
      were found between cases and controls in TIMI major or minor bleeding (0% vs. 
      3%), overall mortality (0% vs. 1.5%), and hospitalization length (4.8 vs. 5.5 
      days). CONCLUSIONS: In-hospital reloading and subsequent maintenance therapy with 
      prasugrel in patients who received thrombolysis and a loading dose of clopidogrel 
      appears to be as safe as in STEMI patients managed by primary PCI; however, 
      larger studies are needed to verify these results.
CI  - (c) The European Society of Cardiology 2015.
FAU - Lerman, Tsahi T
AU  - Lerman TT
AD  - Department of Cardiology, Soroka University Medical Center, Faculty of Health 
      Science, Ben-Gurion University of The Negev, Beer Sheva, Israel.
FAU - Zahger, Doron
AU  - Zahger D
AD  - Department of Cardiology, Soroka University Medical Center, Faculty of Health 
      Science, Ben-Gurion University of The Negev, Beer Sheva, Israel.
FAU - Arad, Jacob
AU  - Arad J
AD  - Department of Emergency Medicine, Yoseftal Medical Center, Eilat, Faculty Of 
      Health Science, Ben-Gurion University of The Negev, Beer Sheva, Israel.
FAU - Gilutz, Harel
AU  - Gilutz H
AD  - Department of Cardiology, Soroka University Medical Center, Faculty of Health 
      Science, Ben-Gurion University of The Negev, Beer Sheva, Israel.
FAU - Reitblat, Olga
AU  - Reitblat O
AD  - Department of Cardiology, Soroka University Medical Center, Faculty of Health 
      Science, Ben-Gurion University of The Negev, Beer Sheva, Israel.
FAU - Shimony, Avi
AU  - Shimony A
AD  - Department of Cardiology, Soroka University Medical Center, Faculty of Health 
      Science, Ben-Gurion University of The Negev, Beer Sheva, Israel 
      ashimony@bgu.ac.il.
LA  - eng
PT  - Journal Article
DEP - 20150422
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
RN  - A74586SNO7 (Clopidogrel)
RN  - G89JQ59I13 (Prasugrel Hydrochloride)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Aged
MH  - Clopidogrel
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/*adverse effects
MH  - Prasugrel Hydrochloride/*administration & dosage/therapeutic use
MH  - ST Elevation Myocardial Infarction/*drug therapy
MH  - Tertiary Healthcare
MH  - Thrombosis/chemically induced/*prevention & control
MH  - Ticlopidine/administration & dosage/*analogs & derivatives/therapeutic use
OTO - NOTNLM
OT  - Clopidogrel
OT  - Prasugrel
OT  - ST-elevation myocardial infarction
OT  - Thrombolysis
EDAT- 2015/04/24 06:00
MHDA- 2017/03/24 06:00
CRDT- 2015/04/24 06:00
PHST- 2014/11/13 00:00 [received]
PHST- 2015/04/04 00:00 [accepted]
PHST- 2015/04/24 06:00 [entrez]
PHST- 2015/04/24 06:00 [pubmed]
PHST- 2017/03/24 06:00 [medline]
AID - 2048872615584075 [pii]
AID - 10.1177/2048872615584075 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2016 Jun;5(3):271-6. doi: 
      10.1177/2048872615584075. Epub 2015 Apr 22.