January 1, 2011Thrombosis and Haemostasis
Intrinsic platelet reactivity before P2Y12 blockade contributes to residual platelet reactivity despite high-level P2Y12 blockade by prasugrel or high-dose clopidogrel
Why the study?
Does intrinsic platelet reactivity to ADP before treatment predict residual platelet reactivity in patients undergoing planned PCI treated with prasugrel or high-dose clopidogrel?
Population
201 patients undergoing cardiac catheterisation for planned percutaneous coronary intervention
Comparison
Prasugrel vs High-dose clopidogrel
Design
RCT, randomised, two-phase crossover, double-blind
Follow-up
15 days
Authors
Discussion
Loading...
Member takes
Implication
Baseline ADP reactivity identifies patients with persistent high on-treatment reactivity despite potent P2Y12 inhibition; confirms intrinsic platelet function as a key determinant.
Structured PICO
Does intrinsic platelet reactivity to ADP before treatment predict residual platelet reactivity in patients undergoing planned PCI treated with prasugrel or high-dose clopidogrel?
P
Population
201 patients undergoing cardiac catheterisation for planned percutaneous coronary intervention
I
Intervention
Prasugrel (60 mg loading dose, 10 mg daily maintenance dose)
C
Comparator
High-dose clopidogrel (600 mg loading dose, 150 mg daily maintenance dose)
O
Outcome
ADP-stimulated platelet-monocyte aggregates, platelet surface P-selectin and platelet aggregation measured pre-treatment, during loading dose (6 h and 18-24 h) and maintenance dose (15 days)surrogate
Patients with high intrinsic platelet reactivity to ADP prior to treatment remain more likely to have high residual platelet reactivity even when treated with potent P2Y12 inhibitors like prasugrel or high-dose clopidogrel.
Cite This Study
Frelinger et al. (2011) studied this question.