Thromb Haemost 2009; 101: 12–13 The combination of aspirin with clopidogrel is currently the mainstay of antiplatelet therapy for patients with acute coronary syndromes (ACS) (1). While aspirin inhibits platelet thromboxane A2 production and platelet activation, clopidogrel inhibits adenosine diphosphate (ADP)-induced platelet activation by blocking the P2Y12 platelet receptor. When added to as...

OBJECTIVE To report a case of successful use of prasugrel following percutaneous coronary intervention with placement of a bare metal stent in a patient with a documented hypersensitivity reaction to clopidogrel. CASE SUMMARY A 61-year-old male with a history of coronary artery disease with coronary stent placement presented with ST-elevation myocardial infarction. The patient had developed S...

Secondary prophylaxis is essential to reduce the adverse cardiovascular outcomes post revascularization in coronary heart disease (CHD). P2Y12 inhibitors (i.e. clopidogrel, prasugrel, or ticagrelor) are effective for this purpose; however, guidelines which inhibitor prescribe differ according patient’s clinical characteristics, and trends their utilization not well studied real-world setting. T...

OBJECTIVE Reduced antiplatelet drug efficacy occurs in conditions of increased platelet turnover, associated with increased proportions of drug-free, that is, uninhibited, platelets. Here, we detail mechanisms by which drug-free platelets promote platelet aggregation in the face of standard antiplatelet therapy. APPROACH AND RESULTS To model standard antiplatelet therapy, platelets were treat...

BACKGROUND Percutaneous coronary interventions are almost always preceded by the loading dose of platelets inhibiter drugs such as clopidogrel or prasugrel and followed by maintenance therapy to decrease the mortality and morbidity due to stent thrombosis. This study was conducted to compare the efficacy of clopidogrel and prasugrel for inhibiting platelet aggregation among patients undergoing ...

It was the objective of this study to determine whether the intrinsic platelet response to adenosine diphosphate (ADP) before thienopyridine exposure contributes to residual platelet reactivity to ADP despite high level P2Y12 blockade by prasugrel (60 mg loading dose [LD]), 10 mg daily maintenance dose [MD]) or high-dose clopidogrel (600 mg LD, 150 mg daily MD). High residual platelet function ...

INTRODUCTION According to the Italian National Report on drug use, thienopyridines (ticlopidine, clopidogrel and prasugrel) and ticagrelor represent the most prescribed antiplatelet agents, beside aspirin. The aim of this study was to analyse the safety profile of these drugs using data from spontaneous reporting of suspected adverse reactions (ADRs). METHODS Suspected ADRs for ticlopidine, c...

BACKGROUND In patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention, a suboptimal degree of platelet inhibition for the first 2 hours after the standard 60 mg loading dose of prasugrel has been described. METHODS AND RESULTS In a prospective, 3-center, nonrandomized, controlled study, 2 sequential groups of P2Y12 inhibitor-naive consecu...

Abstract Funding Acknowledgements Type of funding sources: None. Introduction ST-elevation myocardial infarction (STEMI) requires starting dual antiplatelet therapy as soon possible. Potent P2Y12 inhibitors (prasugrel and ticagrelor) are preferred over clopidogrel. However, real world data is scarce when comparing potent inhibitors. Purpose To compare in-hospital clinical outcome between patien...