Platelet reactivity in diabetic patients undergoing coronary stenting for acute coronary syndrome treated with clopidogrel loading dose followed by prasugrel maintenance therapy

Cuisset, Thomas; Gaborit, Bénédicte; Dubois, Nicole; Quilici, Jacques; Loosveld, Marie; Beguin, Shirley; Loundou, A; Moro, Pierre-Julien; Morange, Pierre‐Emmanuel; Alessi, Marie‐Christine; Dutour, Anne; Bonnet, Jean‐Louis

doi:10.1016/j.ijcard.2012.09.214

Cited by 23 publications

(14 citation statements)

References 35 publications

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“…Interestingly, the cutoff value of 50% defining HTPR seems to remain valid for prasugrel (as determined by a ROC curve analysis). Besides, as previously described for clopidogrel, a low VASP index in patients treated with prasugrel was associated in this study with an increased bleeding risk [30,31]. Besides, as previously described for clopidogrel, a low VASP index in patients treated with prasugrel was associated in this study with an increased bleeding risk [30,31].…”

Section: Vasp Index and New Oral Antiplatelet Agentssupporting

confidence: 78%

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Laine

Paganelli

Bonello

2014

Antiplatelet Therapy in Cardiovascular Disease

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Section: Vasp Index and New Oral Antiplatelet Agentssupporting

confidence: 78%

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Laine

Paganelli

Bonello

2014

Antiplatelet Therapy in Cardiovascular Disease

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“…42,43 These studies were followed by pharmacodynamic investigations specifically designed to assess switching from clopidogrel to prasugrel therapy in patients with ACS or undergoing PCI; 44-50 other retrospective analyses in which the pharmacodynamic effects of switching from clopidogrel to prasugrel therapy were assessed have also been reported. [51][52][53][54][55][56][57] These studies are summarized in Table 3. Overall, the results of these investigations have consistently shown decreased levels of platelet reactivity and reduced rates of HPR when switching from clopidogrel to prasugrel.…”

Section: Results From Pharmacodynamic Investigationsmentioning

confidence: 99%

“…[43][44][45][46][47][48][52][53][54][55] Results of these studies indicate that administering a 60 mg loading dose of prasugrel has potent and immediate platelet inhibitory effects, irrespective of whether the treated patient was receiving maintenance therapy with a 75 mg daily dose or had been exposed to a 600 mg loading dose of clopidogrel * Nature Reviews | Cardiology in the previous 24 h. [43][44][45][46][47][48][52][53][54][55] Similar levels of platelet inhibition to those achieved within hours of administration of a loading dose of prasugrel are observed after 1 week when switching to a 10 mg maintenance dose of prasugrel. 45 Therefore, clinicians can choose either strategy depending on how much immediate potent platelet inhibition is needed.…”

Section: From Cangrelor To Oral Inhibitorsmentioning

confidence: 99%

Switching P2Y12-receptor inhibitors in patients with coronary artery disease

2015

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Dual antiplatelet therapy--the combination of aspirin and a P2Y12-receptor inhibitor--is the cornerstone of treatment of patients with acute coronary syndromes (ACS) and of those undergoing percutaneous coronary intervention. Prasugrel and ticagrelor have more prompt, potent, and predictable antiplatelet effects than those of clopidogrel, and result in reduced ischaemic outcomes in patients with ACS, albeit at the expense of an increased risk of bleeding. However, clopidogrel is still very commonly used. Switching between oral P2Y12-inhibiting therapies occurs very frequently in clinical practice for a variety of reasons, which raises the question of which switching approaches are preferable. In 2015, cangrelor (an intravenous P2Y12-receptor inhibitor) was approved for clinical use, which adds to the conundrum of how to switch between intravenous and oral therapies. Differences in the pharmacology of P2Y12-receptor inhibitors, such as their binding sites (competitive or noncompetitive), half-life, and speed of onset and offset of action, are important factors that might lead to drug interactions when switching between agents. In this Review, we provide an overview of the literature on switching antiplatelet treatment strategies with P2Y12-receptor inhibitors, and discuss practical considerations for switching therapies in the acute and chronic phases of disease presentation.

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“…49 Many other studies exploring the pharmacodynamic profiles of switching from clopidogrel to prasugrel or ticagrelor have been conducted (Tables II and III in the online-only Data Supplement). 18,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] All studies have consistently shown enhanced platelet inhibition when escalating from clopidogrel to prasugrel or ticagrelor, regardless of clinical setting, as well as a reduction in rates of high on-treatment platelet reactivity (HPR), 18,48-70 a well-defined marker of risk of ischemic recurrences, including stent thrombosis. 10,11 These effects are achieved more promptly after administration of an LD compared with an MD regimen.…”

Section: Escalation (Switching From Clopidogrel To Prasugrel or Ticagmentioning

confidence: 99%

International Expert Consensus on Switching Platelet P2Y ₁₂ Receptor–Inhibiting Therapies

et al. 2017

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Dual antiplatelet therapy with aspirin and a P2Y 12 inhibitor is the treatment of choice for the prevention of atherothrombotic events in patients with acute coronary syndromes and for those undergoing percutaneous coronary interventions. The availability of different oral P2Y 12 inhibitors (clopidogrel, prasugrel, ticagrelor) has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. The recent introduction of an intravenous P2Y 12 inhibitor (cangrelor) further adds to the multitude of modalities and settings in which switching therapies may occur. In clinical practice, it is not uncommon to switch P2Y 12 inhibitor, and switching may be attributed to a variety of factors. However, concerns about the safety of switching between these agents have emerged. Practice guidelines have not fully elaborated on how to switch therapies, leaving clinicians with limited guidance on when and how to switch therapies when needed. This prompted the development of this expert consensus document by key leaders from North America and Europe with expertise in basic, translational, and clinical sciences in the field of antiplatelet therapy. This expert consensus provides an overview of the pharmacology of P2Y 12 inhibitors, different modalities and definitions of switching, and available literature and recommendations for switching between P2Y 12 inhibitors. Dual antiplatelet therapy with aspirin and a platelet P2Y 12 receptor antagonist (P2Y 12 inhibitor) is the treatment of choice for the prevention of atherothrombotic events in patients with acute coronary syndromes (ACS) and for those undergoing percutaneous coronary intervention (PCI).1,2 Clopidogrel, prasugrel, and ticagrelor are the most commonly used oral platelet P2Y 12 inhibitors; the use of ticlopidine, the first available P2Y 12 inhibitor, has been largely abandoned. 3Clopidogrel is the only oral P2Y 12 inhibitor indicated for the treatment of patients with stable coronary artery disease.1,2 Although all 3 agents have an indication for use in ACS, current guidelines support the preferential use of prasugrel and ticagrelor over clopidogrel because of their superior net clinical benefits.1,2,4-6 Nevertheless, clopidogrel remains widely prescribed. 7,8 The availability of different oral P2Y 12 inhibitors has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. 9 The recent introduction of an intravenous P2Y 12 inhibitor (ie, cangrelor) further adds to the multitude of modalities and settings in which switching therapies may occur. 6 A variety of factors may contribute to the decision to switch, including the clinical setting, patient characteristics, concomitant therapies, costs, social issues, development of side effects, medication adherence, and patient/physician preference. Therefore, it is not uncommon to change P2Y 12 inhibitor. However, concerns about the safety of switching between these agents have emerged. At present, data from large-scale clinical studie...

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Platelet reactivity in diabetic patients undergoing coronary stenting for acute coronary syndrome treated with clopidogrel loading dose followed by prasugrel maintenance therapy

Cited by 23 publications

References 35 publications

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Switching P2Y12-receptor inhibitors in patients with coronary artery disease

International Expert Consensus on Switching Platelet P2Y ₁₂ Receptor–Inhibiting Therapies

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Platelet reactivity in diabetic patients undergoing coronary stenting for acute coronary syndrome treated with clopidogrel loading dose followed by prasugrel maintenance therapy

Cited by 23 publications

References 35 publications

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Vasodilator‐Stimulated Phosphoprotein (VASP) Assay

Switching P2Y12-receptor inhibitors in patients with coronary artery disease

International Expert Consensus on Switching Platelet P2Y 12 Receptor–Inhibiting Therapies

Contact Info

Product

Resources

About

International Expert Consensus on Switching Platelet P2Y ₁₂ Receptor–Inhibiting Therapies