High and low on-treatment platelet reactivity to P2Y 12 inhibitors in a contemporary cohort of acute coronary syndrome patients undergoing percutaneous coronary intervention
There is compelling evidence supporting the association between high on-treatment platelet reactivity (HPR) and low on-treatment platelet reactivity (LPR) to clopidogrel with atherothrombotic and bleeding events, respectively. However, it is uncertain if current cutoff values should be used in prasu...
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| Veröffentlicht in: | Thrombosis research 2019-03, Vol.175, p.95 |
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| creator | Ferreiro, José Luis Vivas, David De La Hera, Jesús María Marcano, Ana Lucrecia Lugo, Leslie Marisol Gómez-Polo, Juan Carlos Silva, Iria Tello-Montoliu, Antonio Marín, Francisco Roldán, Inmaculada |
| description | There is compelling evidence supporting the association between high on-treatment platelet reactivity (HPR) and low on-treatment platelet reactivity (LPR) to clopidogrel with atherothrombotic and bleeding events, respectively. However, it is uncertain if current cutoff values should be used in prasugrel- or ticagrelor-treated subjects. The objective of this analysis was to evaluate the pharmacodynamic (PD) efficacy of P2Y
antagonists in a contemporary real-world population.
This PD study included 988 patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) and receiving dual therapy with aspirin and a P2Y
inhibitor (clopidogrel, prasugrel or ticagrelor). Platelet function was assessed at day 1 and day 30 post-PCI by VerifyNow P2Y12 assay, multiple electrode aggregometry and vasodilator-stimulated phosphoprotein (VASP) assay.
Clopidogrel-treated patients (n = 324) had greater platelet reactivity than those receiving ticagrelor (n = 469) or prasugrel (n = 195) at both time points (p |
| doi_str_mv | 10.1016/j.thromres.2019.01.021 |
| format | Article |
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antagonists in a contemporary real-world population.
This PD study included 988 patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) and receiving dual therapy with aspirin and a P2Y
inhibitor (clopidogrel, prasugrel or ticagrelor). Platelet function was assessed at day 1 and day 30 post-PCI by VerifyNow P2Y12 assay, multiple electrode aggregometry and vasodilator-stimulated phosphoprotein (VASP) assay.
Clopidogrel-treated patients (n = 324) had greater platelet reactivity than those receiving ticagrelor (n = 469) or prasugrel (n = 195) at both time points (p < 0.001 for all comparisons). No difference between ticagrelor and prasugrel was observed at day 1 with the VerifyNow P2Y12 assay (51.5 ± 2.8 vs. 42.7 ± 3.5 PRUs; p = 0.298), whereas ticagrelor achieved greater platelet inhibition at day 30 (48.1 ± 2.5 vs. 89.2 ± 4.2 PRUs; p < 0.001). Similar results were obtained with the VASP assay. Both prasugrel and ticagrelor had markedly lower HPR rates than clopidogrel and very high rates of LPR at both time points.
Prasugrel and ticagrelor displayed more potent and consistent PD effects than clopidogrel in ACS patients undergoing PCI, with a trend towards greater platelet inhibition with ticagrelor during the maintenance phase of therapy compared to prasugrel.</description><identifier>EISSN: 1879-2472</identifier><identifier>DOI: 10.1016/j.thromres.2019.01.021</identifier><identifier>PMID: 30738371</identifier><language>eng</language><publisher>United States</publisher><ispartof>Thrombosis research, 2019-03, Vol.175, p.95</ispartof><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30738371$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferreiro, José Luis</creatorcontrib><creatorcontrib>Vivas, David</creatorcontrib><creatorcontrib>De La Hera, Jesús María</creatorcontrib><creatorcontrib>Marcano, Ana Lucrecia</creatorcontrib><creatorcontrib>Lugo, Leslie Marisol</creatorcontrib><creatorcontrib>Gómez-Polo, Juan Carlos</creatorcontrib><creatorcontrib>Silva, Iria</creatorcontrib><creatorcontrib>Tello-Montoliu, Antonio</creatorcontrib><creatorcontrib>Marín, Francisco</creatorcontrib><creatorcontrib>Roldán, Inmaculada</creatorcontrib><title>High and low on-treatment platelet reactivity to P2Y 12 inhibitors in a contemporary cohort of acute coronary syndrome patients undergoing percutaneous coronary intervention</title><title>Thrombosis research</title><addtitle>Thromb Res</addtitle><description>There is compelling evidence supporting the association between high on-treatment platelet reactivity (HPR) and low on-treatment platelet reactivity (LPR) to clopidogrel with atherothrombotic and bleeding events, respectively. However, it is uncertain if current cutoff values should be used in prasugrel- or ticagrelor-treated subjects. The objective of this analysis was to evaluate the pharmacodynamic (PD) efficacy of P2Y
antagonists in a contemporary real-world population.
This PD study included 988 patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) and receiving dual therapy with aspirin and a P2Y
inhibitor (clopidogrel, prasugrel or ticagrelor). Platelet function was assessed at day 1 and day 30 post-PCI by VerifyNow P2Y12 assay, multiple electrode aggregometry and vasodilator-stimulated phosphoprotein (VASP) assay.
Clopidogrel-treated patients (n = 324) had greater platelet reactivity than those receiving ticagrelor (n = 469) or prasugrel (n = 195) at both time points (p < 0.001 for all comparisons). No difference between ticagrelor and prasugrel was observed at day 1 with the VerifyNow P2Y12 assay (51.5 ± 2.8 vs. 42.7 ± 3.5 PRUs; p = 0.298), whereas ticagrelor achieved greater platelet inhibition at day 30 (48.1 ± 2.5 vs. 89.2 ± 4.2 PRUs; p < 0.001). Similar results were obtained with the VASP assay. Both prasugrel and ticagrelor had markedly lower HPR rates than clopidogrel and very high rates of LPR at both time points.
Prasugrel and ticagrelor displayed more potent and consistent PD effects than clopidogrel in ACS patients undergoing PCI, with a trend towards greater platelet inhibition with ticagrelor during the maintenance phase of therapy compared to prasugrel.</description><issn>1879-2472</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpFUMtOwzAQtJAQLYVfqPwDCX4Rx0dUAUWqBIdeOFWOs2lcJXZku0X9KP4RI0Ccdmd3dma0CC0pKSmh1d2hTH3wY4BYMkJVSWhJGL1Ac1pLVTAh2Qxdx3gghEqq7q_QjBPJay7pHH2u7b7H2rV48B_YuyIF0GkEl_A06AQDJJwnJtmTTWecPH5j75gybF1vG5t8iLnFGhvvEoyTDzqcM-h9SNh3WJtjgoyDd9-LeHZtjgp40slmk4iProWw99bt8QQhs7UDf4z_JzbrhlPmWu9u0GWnhwi3v3WBtk-P29W62Lw-v6weNsWkeCqMUER2vDFcaF0LAgpq0hipmYG61VXFuDZG0k6YSgmhaw4dqUwL0nAlaMcXaPkjOx2bEdrdFOyYo-z-3sa_ANw6dsA</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Ferreiro, José Luis</creator><creator>Vivas, David</creator><creator>De La Hera, Jesús María</creator><creator>Marcano, Ana Lucrecia</creator><creator>Lugo, Leslie Marisol</creator><creator>Gómez-Polo, Juan Carlos</creator><creator>Silva, Iria</creator><creator>Tello-Montoliu, Antonio</creator><creator>Marín, Francisco</creator><creator>Roldán, Inmaculada</creator><scope>NPM</scope></search><sort><creationdate>20190301</creationdate><title>High and low on-treatment platelet reactivity to P2Y 12 inhibitors in a contemporary cohort of acute coronary syndrome patients undergoing percutaneous coronary intervention</title><author>Ferreiro, José Luis ; Vivas, David ; De La Hera, Jesús María ; Marcano, Ana Lucrecia ; Lugo, Leslie Marisol ; Gómez-Polo, Juan Carlos ; Silva, Iria ; Tello-Montoliu, Antonio ; Marín, Francisco ; Roldán, Inmaculada</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p93t-c4907f3bc34aa840e9e80bc7a2ce8da6623acc71f4c6944a83ef06cde7c3941f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ferreiro, José Luis</creatorcontrib><creatorcontrib>Vivas, David</creatorcontrib><creatorcontrib>De La Hera, Jesús María</creatorcontrib><creatorcontrib>Marcano, Ana Lucrecia</creatorcontrib><creatorcontrib>Lugo, Leslie Marisol</creatorcontrib><creatorcontrib>Gómez-Polo, Juan Carlos</creatorcontrib><creatorcontrib>Silva, Iria</creatorcontrib><creatorcontrib>Tello-Montoliu, Antonio</creatorcontrib><creatorcontrib>Marín, Francisco</creatorcontrib><creatorcontrib>Roldán, Inmaculada</creatorcontrib><collection>PubMed</collection><jtitle>Thrombosis research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ferreiro, José Luis</au><au>Vivas, David</au><au>De La Hera, Jesús María</au><au>Marcano, Ana Lucrecia</au><au>Lugo, Leslie Marisol</au><au>Gómez-Polo, Juan Carlos</au><au>Silva, Iria</au><au>Tello-Montoliu, Antonio</au><au>Marín, Francisco</au><au>Roldán, Inmaculada</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High and low on-treatment platelet reactivity to P2Y 12 inhibitors in a contemporary cohort of acute coronary syndrome patients undergoing percutaneous coronary intervention</atitle><jtitle>Thrombosis research</jtitle><addtitle>Thromb Res</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>175</volume><spage>95</spage><pages>95-</pages><eissn>1879-2472</eissn><abstract>There is compelling evidence supporting the association between high on-treatment platelet reactivity (HPR) and low on-treatment platelet reactivity (LPR) to clopidogrel with atherothrombotic and bleeding events, respectively. However, it is uncertain if current cutoff values should be used in prasugrel- or ticagrelor-treated subjects. The objective of this analysis was to evaluate the pharmacodynamic (PD) efficacy of P2Y
antagonists in a contemporary real-world population.
This PD study included 988 patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) and receiving dual therapy with aspirin and a P2Y
inhibitor (clopidogrel, prasugrel or ticagrelor). Platelet function was assessed at day 1 and day 30 post-PCI by VerifyNow P2Y12 assay, multiple electrode aggregometry and vasodilator-stimulated phosphoprotein (VASP) assay.
Clopidogrel-treated patients (n = 324) had greater platelet reactivity than those receiving ticagrelor (n = 469) or prasugrel (n = 195) at both time points (p < 0.001 for all comparisons). No difference between ticagrelor and prasugrel was observed at day 1 with the VerifyNow P2Y12 assay (51.5 ± 2.8 vs. 42.7 ± 3.5 PRUs; p = 0.298), whereas ticagrelor achieved greater platelet inhibition at day 30 (48.1 ± 2.5 vs. 89.2 ± 4.2 PRUs; p < 0.001). Similar results were obtained with the VASP assay. Both prasugrel and ticagrelor had markedly lower HPR rates than clopidogrel and very high rates of LPR at both time points.
Prasugrel and ticagrelor displayed more potent and consistent PD effects than clopidogrel in ACS patients undergoing PCI, with a trend towards greater platelet inhibition with ticagrelor during the maintenance phase of therapy compared to prasugrel.</abstract><cop>United States</cop><pmid>30738371</pmid><doi>10.1016/j.thromres.2019.01.021</doi></addata></record> |
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| title | High and low on-treatment platelet reactivity to P2Y 12 inhibitors in a contemporary cohort of acute coronary syndrome patients undergoing percutaneous coronary intervention |
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