Abstract:
AIMS:To examine the extent of platelet inhibition by prasugrel vs. clopidogrel in a TRITON-TIMI 38 substudy. METHODS AND RESULTS:TRITON-TIMI 38 randomized acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) to prasugrel or standard dose clopidogrel. Selected sites prospectively enrolled TRITON-TIMI 38 patients to evaluate adenosine diphosphate (ADP)-attenuated phosphorylation of platelet vasodilator-stimulated phosphoprotein (VASP) (n = 125 patients) and, in a subset (n = 31 patients), ADP-stimulated platelet aggregation. VASP platelet reactivity index (PRI) was lower in prasugrel-treated patients than in clopidogrel-treated patients at 1-2 h post-PCI (>or=1 h after loading dose) (P < 0.001) and at 30 days (P < 0.001). Maximal platelet aggregation to 20 microM ADP was lower in prasugrel-treated patients than in clopidogrel-treated patients at 1-2 h (P = 0.004) and 30 days (P = 0.03). Results were similar with 5 microM ADP. Thienopyridine hyporesponsiveness, prespecified as VASP PRI >50%, was more frequent in clopidogrel-treated patients than in prasugrel-treated patients at 1-2 h (P < 0.001) and 30 days (P = 0.03). CONCLUSIONS:The TRITON-TIMI 38 platelet substudy shows that prasugrel results in greater inhibition of ADP-mediated platelet function in ACS patients than clopidogrel, supporting the hypothesis that greater platelet inhibition leads to a lower incidence of ischaemic events and more bleeding both early and late following PCI.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Michelson AD,Frelinger AL 3rd,Braunwald E,Downey WE,Angiolillo DJ,Xenopoulos NP,Jakubowski JA,Li Y,Murphy SA,Qin J,McCabe CH,Antman EM,Wiviott SD,TRITON-TIMI 38 Investigators.doi
10.1093/eurheartj/ehp159subject
Has Abstractpub_date
2009-07-01 00:00:00pages
1753-63issue
14eissn
0195-668Xissn
1522-9645pii
ehp159journal_volume
30pub_type
杂志文章,多中心研究,随机对照试验abstract:AIMS:The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive dia...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
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