Key result
Adding a prasugrel loading dose in ACS patients reduced high on-treatment platelet reactivity from 58.5% after a clopidogrel loading dose to 7.1% at 6 hours and 0% at 72 hours.
Why the study?
Does transferring from a clopidogrel loading dose to a prasugrel loading dose effectively reduce high on-treatment platelet reactivity in ACS patients undergoing PCI?
Population
Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI)
Comparison
Prasugrel 60-mg or 30-mg loading dose… vs Prasugrel 60-mg or 30-mg loading dose…
Design
RCT, randomised, double-blind
Follow-up
72 hours
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Supports prasugrel loading to rapidly eliminate high on-treatment platelet reactivity in ACS patients after clopidogrel; extends evidence for genotype-independent P2Y12 switching in PCI.
RCT
Double-blind
Randomized
Does transferring from a clopidogrel loading dose to a prasugrel loading dose effectively reduce high on-treatment platelet reactivity in ACS patients undergoing PCI?
Absolute Event Rate: 7.1% vs 58.5%
Administering a prasugrel loading dose to ACS patients who have already received a clopidogrel loading dose effectively eliminates high on-treatment platelet reactivity by 72 hours, irrespective of CYP2C19 genotype.
A 2014 study conducted an RCT in Acute coronary syndrome (ACS). Prasugrel loading dose vs. Clopidogrel 600-mg loading dose was evaluated on High on-treatment platelet reactivity (HPR, PRU ≥240). Adding a prasugrel loading dose in ACS patients reduced high on-treatment platelet reactivity from 58.5% after a clopidogrel loading dose to 7.1% at 6 hours and 0% at 72 hours.
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