Key result
Switching from ticagrelor to prasugrel resulted in a similar prevalence of high-on-treatment platelet reactivity.
Why the study?
The degree of platelet inhibition between ticagrelor and prasugrel needed to be compared in patients undergoing percutaneous coronary intervention for acute coronary syndrome.
Does prasugrel provide similar platelet inhibition compared to ticagrelor in patients undergoing PCI for ACS?
Does prasugrel provide similar platelet inhibition compared to ticagrelor in patients undergoing PCI for ACS?
Ticagrelor and prasugrel provide similar platelet inhibition in ACS patients undergoing PCI, and switching between them is safe and effective.
Answers are grounded in this paper and cite their sources.
Supports similar platelet inhibition after switching in ACS PCI; hypothesis-generating and should not change practice without randomized data.
AIM: To compare the degree of platelet inhibition between ticagrelor and prasugrel in patients undergoing percutaneous coronary intervention for acute coronary syndrome. METHODS: Platelet function was assessed by impedance aggregometry after 30-90 days of therapy with acetylsalicylic acid and ticagrelor and over 15 days after switching to prasugrel. High-on-treatment platelet reactivity (HRPR) was defined for ADP test results above the upper limit of normal. RESULTS: A total of 105 patients were included, 81.9% males and 33.3% people with diabetes, with a mean age of 60.8 ± 8.1 years. Mean platelet reactivity was not significantly different between the two antiplatelet strategies, as the prevalence of HRPR (8.6 vs 12.3%, P = 0.50). Switching between the two antiplatelet agents was safe and well tolerated, and effectively reduced platelet reactivity in over 95% of the patients (only 3.8% of the study population displaying ineffective response to both drugs). CONCLUSION: Ticagrelor and prasugrel have a similar effect on platelet reactivity. Switching between the two drugs can be safely done.
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Verdoia et al. (2021) studied Acute coronary syndrome undergoing percutaneous coronary intervention (n=105). Prasugrel vs. Ticagrelor was evaluated on Prevalence of high-on-treatment platelet reactivity (HRPR) (p=0.50). Switching from ticagrelor to prasugrel resulted in a similar prevalence of high-on-treatment platelet reactivity.
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