Key result
Prasugrel loading associated with greater platelet inhibition than clopidogrel at 12 to 24 hours.
Why the study?
Does prasugrel improve platelet inhibition compared to clopidogrel in patients undergoing successful PCI?
Observational (n=83)
Does prasugrel improve platelet inhibition compared to clopidogrel in patients undergoing successful PCI?
Absolute Event Rate: 49% vs 160%
p-value: p=<0.001
Prasugrel provides greater platelet inhibition than clopidogrel after PCI, which correlates with reduced ischemic events but increased bleeding risk.
May favor prasugrel for superior platelet inhibition post-PCI; leaves open whether this alters hard outcomes beyond TRITON.
ful PCI (clopidogrel = 42; prasugrel = 41). Twelve to 24 hours after receiving the loading dose, patients treated with prasugrel presented greater platelet inhibition compared to those treated with clopidogrel evaluated with the VerifyNow-P2Y12 system [median 49 (9-78) vs. 160 (82-224), respectively, p < 0.001]. Prasugrel has greater clinical efficacy compared to clopidogrel due to its better pharmacodynamic profile. This was demonstrated by the TRITON (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel) TIMI (Thrombolysis in Myocardial Infarction) trial, which reported a significant reduction in death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (12) Yet, this reduction in the incidence of ischemic events was at the expense of a higher rate of bleeding in patients treated with prasugrel, although these patients had greater net clinical benefit. (12)
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Tello‐Montoliu et al. (2012) conducted an observational in Percutaneous Coronary Intervention (PCI) (n=83). Prasugrel vs. Clopidogrel was evaluated on Platelet inhibition evaluated with the VerifyNow-P2Y12 system (p=<0.001). Prasugrel resulted in significantly greater platelet inhibition compared to clopidogrel 12 to 24 hours after a loading dose (median 49 vs 160; p<0.001).
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