PMID- 29731189
OWN - NLM
STAT- MEDLINE
DCOM- 20191001
LR  - 20191210
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 72
IP  - 5
DP  - 2018 Nov
TI  - Potent effect of prasugrel on acute phase resolution of intra-stent 
      athero-thrombotic burden after percutaneous intervention to acute coronary 
      syndrome.
PG  - 403-410
LID - S0914-5087(18)30111-4 [pii]
LID - 10.1016/j.jjcc.2018.04.004 [doi]
AB  - BACKGROUND: Recent studies suggested protruding thrombus and atheroma after stent 
      placement could be a substrate for subsequent adverse ischemic events. Although 
      protruded atherothrombotic burden can be assessed as intra-stent tissue (IST) by 
      optical coherence tomography (OCT), the effects of potent antiplatelet therapy on 
      the acute phase resolution of IST in patients with acute coronary syndrome (ACS) 
      was unknown. METHODS: Ninety-six consecutive ACS patients with multi-vessel 
      disease were enrolled in this prospective registry. In combination with aspirin, 
      either clopidogrel or prasugrel was selected according to the date of enrolment. 
      OCT examination was done immediately after percutaneous coronary intervention 
      (post-PCI) and 10 days after index PCI (follow-up acute phase) to calculate 
      averaged IST score as semi-quantitative measures of IST. High residual platelet 
      reactivity (HRPR) was defined as platelet reactivity units (PRU)>/=240 by VerifyNow 
      P2Y12 assay (Accumetrics Inc., San Diego, CA, USA). RESULTS: Thirty two patients 
      (38 stents) were enrolled in the prasugrel group and sixty four patients (72 
      stents) in the clopidogrel group. Averaged IST scores post-PCI were similar 
      between the two groups (0.68+/-0.41 vs. 0.68+/-0.40, p=0.99), which decreased in all 
      of the prasugrel group and in 87.5% of the clopidogrel group (p=0.02). 
      Consequently, changes in averaged IST score (delta averaged IST score) were 
      significantly greater in the prasugrel group compared to those in the clopidogrel 
      group (-0.411+/-0.288 vs. -0.299+/-0.270, p=0.045). The frequency of HRPR was 
      significantly lower in the prasugrel group (10.0% vs 32.4%, p=0.028). 
      CONCLUSIONS: Prasugrel plus aspirin achieved greater acute phase reduction of IST 
      than clopidogrel plus aspirin, which might underlie the clinical benefit of 
      potent antiplatelet therapy in ACS. (UMIN000018751).
CI  - Copyright (c) 2018. Published by Elsevier Ltd.
FAU - Tsukiyama, Yoshiro
AU  - Tsukiyama Y
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan.
FAU - Kozuki, Amane
AU  - Kozuki A
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Shinke, Toshiro
AU  - Shinke T
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan. Electronic address: 
      shinke@med.kobe-u.ac.jp.
FAU - Otake, Hiromasa
AU  - Otake H
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan.
FAU - Kijima, Yoichi
AU  - Kijima Y
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Masano, Tomoya
AU  - Masano T
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Nagoshi, Ryoji
AU  - Nagoshi R
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Shibata, Hiroyuki
AU  - Shibata H
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Takeshige, Ryo
AU  - Takeshige R
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan.
FAU - Yanaka, Ken-Ichi
AU  - Yanaka KI
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan.
FAU - Shite, Junya
AU  - Shite J
AD  - Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
FAU - Hirata, Ken-Ichi
AU  - Hirata KI
AD  - Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, 
      Department of Internal Medicine, Kobe, Japan.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20180504
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - G89JQ59I13 (Prasugrel Hydrochloride)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Acute Coronary Syndrome/physiopathology/*surgery
MH  - Aged
MH  - Aspirin/therapeutic use
MH  - Blood Platelets/drug effects
MH  - Clopidogrel/therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/*adverse effects
MH  - Plaque, Atherosclerotic/drug therapy/etiology
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Postoperative Complications/*drug therapy/etiology
MH  - Prasugrel Hydrochloride/*therapeutic use
MH  - Prospective Studies
MH  - Registries
MH  - Stents/adverse effects
MH  - Thrombosis/*drug therapy/etiology
MH  - Tomography, Optical Coherence
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute phase
OT  - Intra-stent tissue
OT  - Optical coherence tomography
OT  - Platelet reactivity
OT  - Prasugrel
EDAT- 2018/05/08 06:00
MHDA- 2019/10/02 06:00
CRDT- 2018/05/08 06:00
PHST- 2017/12/20 00:00 [received]
PHST- 2018/03/11 00:00 [revised]
PHST- 2018/04/02 00:00 [accepted]
PHST- 2018/05/08 06:00 [pubmed]
PHST- 2019/10/02 06:00 [medline]
PHST- 2018/05/08 06:00 [entrez]
AID - S0914-5087(18)30111-4 [pii]
AID - 10.1016/j.jjcc.2018.04.004 [doi]
PST - ppublish
SO  - J Cardiol. 2018 Nov;72(5):403-410. doi: 10.1016/j.jjcc.2018.04.004. Epub 2018 May 
      4.