03257nam a22003257a 4500
170428s20172017 xxu||||| |||| 00| 0 eng d
2047-9980
Ovid MEDLINE(R)
28356282
Impact of Diabetes Mellitus on the Pharmacodynamic Effects of Ticagrelor Versus Clopidogrel in Troponin-Negative Acute Coronary Syndrome Patients Undergoing Ad Hoc Percutaneous Coronary Intervention.
Journal of the American Heart Association. 6(4), 2017 Mar 29
J Am Heart Assoc. 6(4), 2017 Mar 29
Journal of the American Heart Association
2017
FY2017
2017-05-06
BACKGROUND: Diabetes mellitus (DM) is associated with enhanced platelet reactivity and impaired response to oral antiplatelet therapy, including clopidogrel. This post hoc analysis investigated the pharmacodynamic effects of ticagrelor versus clopidogrel loading dose (LD) in troponin-negative acute coronary syndrome patients with or without DM undergoing percutaneous coronary intervention in the Ad Hoc PCI study.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01603082.
CONCLUSIONS: Compared with clopidogrel, ticagrelor achieved faster, enhanced platelet inhibition and reduced high on-treatment platelet reactivity rates, in DM and non-DM patients.
Copyright © 2017 The Authors and AstraZeneca. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
METHODS AND RESULTS: Patients randomized (1:1) to receive ticagrelor 180 mg LD or clopidogrel 600 mg LD were assessed by diabetic status. Platelet reactivity (P2Y<sub>12</sub> reaction units [PRU] on VerifyNow<sup></sup> assay) was measured pre-LD, at 0.5, 2, and 8 hours post-LD, and at the end of the percutaneous coronary intervention. The primary endpoint was PRU levels 2 hours post-LD; secondary endpoints included rates of high on-treatment platelet reactivity (PRU>208). Of 100 randomized patients, 51 received ticagrelor (DM, n=20; non-DM, n=31) and 49 clopidogrel (DM, n=16; non-DM, n=33). At 2 hours post-LD, mean (SD) PRU levels in DM patients were 130.1 (111.7) with ticagrelor versus 287.6 (71.9) with clopidogrel (mean [95%CI] difference -157.5 [-225.3, -89.8]; P<0.001); in non-DM patients, they were 75.3 (75.7) versus 243.0 (72.4) (mean difference -167.7 [-207.1, -128.3]; P<0.001). High on-treatment platelet reactivity rates at 2 hours post-LD were also significantly (P<0.001) reduced with ticagrelor versus clopidogrel in DM and non-DM patients. Between-treatment differences for PRU and high on-treatment platelet reactivity were not significant at earlier time points but were at 8 hours post-LD (P<0.001).
English
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
Journal Article
Waksman, Ron
Angiolillo DJ, Carlson GF, Dangas G, Franchi F, Khan ND, Mehran R, Raveendran G, Rollini F, Sweeny JM, Teng R, Waksman R, Zhao Y
https://dx.doi.org/10.1161/JAHA.117.005650
https://dx.doi.org/10.1161/JAHA.117.005650
ART
Article
0
0
0
0
Article
authcat
authcat
2017-05-06
0
28356282
28356282
2017-05-06
2017-05-06
ART
2159
2159