Key result
Switching from prasugrel to ticagrelor rapidly achieved an adequate platelet response in a patient with subacute stent thrombosis and genetically-mediated prasugrel resistance.
Why the study?
Does switching to ticagrelor improve platelet response in a patient with prasugrel resistance and subacute stent thrombosis?
Case Report (n=1)
Does switching to ticagrelor improve platelet response in a patient with prasugrel resistance and subacute stent thrombosis?
Ticagrelor can successfully overcome prasugrel resistance in patients presenting with subacute stent thrombosis.
Answers are grounded in this paper and cite their sources.
May support ticagrelor switch after prasugrel failure; hypothesis-generating case report requiring prospective confirmation.
Prasugrel is a widely used antiplatelet agent in the setting of percutaneous coronary intervention. In case of resistance to this third-generation thienopyridine, choices of alternative drugs remain limited. Here, we describe a case of a 49-year-old man with stent thrombosis occurring 5 days after drug-eluting stent implantation despite a well-conducted antiplatelet therapy with aspirin and prasugrel. Evaluation of platelet functions by different tests revealed prasugrel resistance. Genotyping for various CYP single-nucleotide polymorphisms showed that the patient carried mutant alleles encoding enzymes CYP2B6 and CYP2C9 involved in prasugrel metabolic pathway. Strikingly, an adequate platelet response was rapidly obtained after switching from prasugrel to ticagrelor.
No takes yet. Share an insight, caveat, or question.
Fiore et al. (2013) conducted a case report in Stent thrombosis and prasugrel resistance (n=1). Ticagrelor vs. Prasugrel was evaluated on Platelet response. Switching from prasugrel to ticagrelor rapidly achieved an adequate platelet response in a patient with subacute stent thrombosis and genetically-mediated prasugrel resistance.
Synapse has enriched 10 related papers. Consider them for comparative context: