A pharmacodynamic comparison of prasugrel vs. high-dose clopidogrel in patients with type 2 diabetes mellitus and coronary artery disease: results of the Optimizing anti-Platelet Therapy In diabetes MellitUS (OPTIMUS)-3 Trial
Why the study?
Does prasugrel provide greater platelet inhibition than high-dose clopidogrel in patients with type 2 diabetes mellitus and coronary artery disease?
Population
35 patients with type 2 diabetes mellitus and coronary artery disease (CAD)
Comparison
Prasugrel 60 mg loading dose / 10 mg maintenance… vs Clopidogrel 600 mg loading dose / 150 mg…
Design
RCT, randomly assigned, crossover study, double-blind
Follow-up
7 days per treatment period
Authors
Discussion
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Member takes
Implication
Supports prasugrel over high-dose clopidogrel for platelet inhibition in T2DM-CAD; confirms RCT superiority in this high-risk population.
Structured PICO
Does prasugrel provide greater platelet inhibition than high-dose clopidogrel in patients with type 2 diabetes mellitus and coronary artery disease?
P
Population
35 patients with type 2 diabetes mellitus and coronary artery disease (CAD)
I
Intervention
Prasugrel 60 mg loading dose (LD) / 10 mg maintenance dose (MD) over a 1-week treatment period
C
Comparator
Clopidogrel 600 mg loading dose (LD) / 150 mg maintenance dose (MD) over a 1-week treatment period
O
Outcome
Platelet inhibition by VerifyNow® P2Y12 assay at 4 h post-loading dosesurrogate
In patients with type 2 diabetes and CAD, standard-dose prasugrel achieves significantly greater platelet inhibition than double-dose clopidogrel.
Cite This Study
Angiolillo et al. (2011) studied this question.