Optimal platelet inhibition in patients undergoing PCI: Data from the Multicenter Registry of High-Risk Percutaneous Coronary Intervention and Adequate Platelet Inhibition (MR PCI) study

Mardikar, H.M.; Hiremath, M.S.; Moliterno, David J.; Mathew, Rony; Arora, Rangolee; Deo, Dhananjay; Hiremath, Jagdish; Deshpande, Niteen; Khan, Aziz; Joseph, Jacob; Mukherjee, Debabrata

doi:10.1016/j.ahj.2007.05.007

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…A flow chart depicting the timing of PFA testing with adjustments in therapy outlines our proposed practice with the addition of prasugrel (Figure 6). Until prospective validation of these approaches in RCTs, as with all medical practice, we will need to base treatment decisions on the applicable main and subgroup results of trials without individualized PFA evaluations 71. Potent new agents like prasugrel may obviate the need for platelet function assays to assess efficacy but may still be beneficial to predict safety.…”

Section: Alternative Regimens To Consider In Diabeticsmentioning

confidence: 99%

Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview

Hillegass

Brott²,

Dobbs³

et al. 2011

VHRM

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Diabetics have a prothrombotic state that includes increased platelet reactivity. This contributes to the less favorable clinical outcomes observed in diabetics experiencing acute coronary syndromes as well as stable coronary artery disease. Many diabetics are relatively resistant to or have insufficient response to several antithrombotic agents. In the setting of percutaneous coronary intervention, hyporesponsiveness to clopidogrel is particularly common among diabetics. Several strategies have been examined to further enhance the benefits of oral antiplatelet therapy in diabetics. These include increasing the dose of clopidogrel, triple antiplatelet therapy with cilostazol, and new agents such as prasugrel. The large TRITON TIMI 38 randomized trial compared clopidogrel to prasugrel in the setting of percutaneous coronary intervention for acute coronary syndromes. The diabetic subgroup (n = 3146) experienced considerable incremental benefit with a 4.8% reduction in cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke at 15-month follow-up with prasugrel treatment. Among diabetics on insulin this combined endpoint was reduced by 7.9% at 15 months. Major bleeding was not increased in the diabetic subgroup. This confirms the general hypothesis that more potent oral antiplatelet therapy can partially overcome the prothrombotic milieu and safely improve important clinical outcomes in diabetics.

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Section: Alternative Regimens To Consider In Diabeticsmentioning

confidence: 99%

Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview

Hillegass

Brott²,

Dobbs³

et al. 2011

VHRM

View full text Add to dashboard Cite

show abstract

“…All studies mentioned ‘random’, but the method of randomization sequence generation was stated explicitly in five trials, of which three studies used computer generated random numbers, block randomization, random number table, respectively, two studies randomized the patients according to the order of enrollment or the date of admission. No studies mentioned specifically allocation concealment scheme except for one study referred to envelope hidden. Five studies reported blinding.…”

Section: Resultsmentioning

confidence: 99%

“…No studies mentioned specifically allocation concealment scheme except for one study referred to envelope hidden. Five studies reported blinding. All included studies were successfully reported the details of participants who withdrew or were lost to follow‐up.…”

Section: Resultsmentioning

confidence: 99%

“…The results of the literature search were shown in Figure 1. Finally, we identified nine eligible studies with 1256 patients, of these, four articles [19][20][21][22] in Chinese, five articles [23][24][25][26][27]…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Five studies 19,[22][23][24]26 reported blinding. All included studies were successfully reported the details of participants who withdrew or were lost to follow-up.…”

Section: Quality Assessmentmentioning

confidence: 99%

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