TY  - BOOK
AU  - Chen, Fang
AU  - Drenning, David
AU  - Lhermusier, Thibault
AU  - Lipinski, Michael J
AU  - Marso, Steven
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Switching patients from clopidogrel to prasugrel in acute coronary syndrome: impact of the clopidogrel loading dose on platelet reactivity
SN  - 0896-4327
PY  - 2014///
KW  - *Acute Coronary Syndrome/th [Therapy]
KW  - *Platelet Activation/de [Drug Effects]
KW  - *Platelet Aggregation Inhibitors/ad [Administration & Dosage]
KW  - *Platelet Aggregation/de [Drug Effects]
KW  - *Prasugrel Hydrochloride/ad [Administration & Dosage]
KW  - *Ticlopidine/aa [Analogs & Derivatives]
KW  - Dose-Response Relationship, Drug
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Percutaneous Coronary Intervention
KW  - Ticlopidine/ad [Administration & Dosage]
KW  - MedStar Washington Hospital Center
KW  - Clinical Trial
KW  - Journal Article
KW  - Multicenter Study
KW  - Research Support, Non-U.S. Gov't
N2  - BACKGROUND: Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) commonly receive a clopidogrel LD prior to angiography. Switching these patients to prasugrel may be desirable because higher platelet inhibition is expected; CONCLUSIONS: Platelet reactivity with prasugrel 60mg added to a clopidogrel 600-mg LD was not significantly different compared with prasugrel 60mg alone in ACS patients undergoing PCI.Copyright © 2014, Wiley Periodicals, Inc; METHODS: In this open-label, multicenter, nonrandomized trial, 75 patients were categorized into 2 treatment strategies: Those who received a clopidogrel 600-mg LD and received a reloading dose of prasugrel 60mg (clopidogrel/prasugrel group) and those who did not receive a clopidogrel LD and received a prasugrel 60-mg LD (prasugrel group). Platelet reactivity was assessed using VerifyNow P2Y12 reaction units (PRU) and Platelet Reactivity Index vasodilator-stimulated phosphoprotein phosphorylation (PRI-VASP) at 3 different times: at the sheath insertion prior to prasugrel LD, 4hours after prasugrel LD, and at discharge; OBJECTIVES: The present study aimed to assess the pharmacodynamic response of a prasugrel 60-mg loading dose (LD) alone compared with prasugrel 60mg added to clopidogrel 600mg; RESULTS: Four hours after prasugrel LD, platelet reactivity did not differ between the clopidogrel/prasugrel group and the prasugrel group according to the VerifyNow assay (median PRU 23 [5-71] vs. 54 [5-91], respectively; P=0.18) and the VASP assay (median PRI 8.67 [4.51-16.85] versus 8.03 [4.82-21.72], respectively; P=1.0). No significant differences in PRU and PRI were observed at discharge. Few bleeding events were reported without any significant differences between the 2 groups
UR  - http://dx.doi.org/10.1111/joic.12139
ER  -