Relationship between post‐treatment platelet reactivity and ischemic and bleeding events at 1‐year follow‐up in patients receiving prasugrel

Bonello, Laurent; Mancini, Julien; Pansiéri, Michel; Maillard, Luc; Rossi, P; Collet, F; Jouve, Bernard; Wittenberg, Olivier; Laine, Marc; Michelet, Pierre; Bessereau, Jacques; Lemesle, Gilles; Dignat-George, Françoise; Paganelli, Franck; Camoin-Jau, Laurence

doi:10.1111/j.1538-7836.2012.04875.x

Cited by 121 publications

(91 citation statements)

References 26 publications

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“…With regard to the evaluation of platelet reactivity responses to P2Y12 inhibitors, platelet function monitoring can not only predict ischemia but also bleeding events. 17 In our 30-day Our current study produced results in line with previous head-to-head comparison studies of prasugrel and ticagrelor in STEMI patients. 4,7 Previous studies have focused on platelet inhibition in the very early phase, whereas we focused on the 48-h period as a bridging time point between acute and chronic antiplatelet therapy.…”

Section: Population and Clinical Baseline Characteristicssupporting

confidence: 86%

Comparison of Prasugrel and Ticagrelor Antiplatelet Effects in Korean Patients Presenting With ST-Segment Elevation Myocardial Infarction

Lee

Jin

Kim

et al. 2015

Circ J

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Section: Population and Clinical Baseline Characteristicssupporting

confidence: 86%

Comparison of Prasugrel and Ticagrelor Antiplatelet Effects in Korean Patients Presenting With ST-Segment Elevation Myocardial Infarction

Lee

Jin

Kim

et al. 2015

Circ J

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“…6,9 It is widely accepted that HPR is associated with adverse events, whereas some studies have also suggested a possible link between LPR and bleeding. [24][25][26][27] During the 30 days of follow-up in this study, no major bleeding event occurred in either treatment arm. Eight patients (5 allocated to the ticagrelor arm and 3 to the clopidogrel arm) experienced BARC1 or BARC2 bleeding complications.…”

Section: Discussionmentioning

confidence: 97%

Validation of a New ELISA-Based Vasodilator-Associated Stimulated Phosphoprotein Phosphorylation Assay to Assess Platelet Reactivity Index in a Chinese Population

Ding

Chen

et al. 2017

Clin Appl Thromb Hemost

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The level of platelet reactivity during P2Y12-adenosine diphosphate receptor antagonist is associated with ischemic and bleeding risks following percutaneous coronary intervention in acute coronary syndrome. Determining platelet reactivity inhibition may be valuable for confirming effective platelet inhibition for individual patients and identifying patients at risk of bleeding. The enzymelinked immunosorbent assay (ELISA)-based vasodilator-stimulated phosphoprotein (VASP) assay offers unique advantages over other methods and has not been used in the Chinese population. We enrolled 10 healthy volunteers and 54 patients with acute coronary syndrome. The volunteers received no treatment, and patients were administered a loading dose of clopidogrel or ticagrelor. The platelet reactivity index (PRI) was measured using flow cytometry (FC)-VASP and ELISA-VASP at baseline and 8-hour postloading dose. Blood samples of healthy volunteers and clopidogrel-or ticagrelor-treated patients were frozen and stored for 1, 2, and 4 weeks after initial activation. All frozen samples were tested using ELISA-VASP. The PRI assessed by FC-VASP and ELISA-VASP correlated well showing a high degree of consistency in identifying high or low on-treatment platelet reactivity. No significant time-dependent changes in PRI results were observed in frozen samples stored up to 4 weeks compared to nonfrozen samples. The PRI of ticagrelor-treated patients was lower than that of clopidogrel-treated patients. The ELISA-VASP effectively assesses the PRI, and results obtained from frozen specimens are unaffected by storage and shipment prior to assay. Ticagrelor was superior to clopidogrel in decreasing the PRI.

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“…The efficacy and safety results of TRITON-TIMI 38 and the PRASFIT studies should be discussed in the context of the therapeutic window of antiplatelet activity. This concept implies that the risk of thrombotic events is increased in patients with high on-treatment platelet reactivity (i.e., low platelet inhibition), and that the risk of bleeding is increased in patients with low on-treatment platelet reactivity (i.e., high platelet inhibition) [26][27][28][29].…”

Section: Risk Of Bleeding In the Prasfit Studiesmentioning

confidence: 99%

Risk of bleeding and repeated bleeding events in prasugrel-treated patients: a review of data from the Japanese PRASFIT studies

Nishikawa

Isshiki

Kimura

et al. 2017

Cardiovasc Interv and Ther

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Prasugrel is a third-generation thienopyridine that achieves potent platelet inhibition with less pharmacological variability than other thienopyridines. However, clinical experience suggests that prasugrel may be associated with a higher risk of de novo and recurrent bleeding events compared with clopidogrel in Japanese patients undergoing percutaneous coronary intervention (PCI). In this review, we evaluate the risk of bleeding in Japanese patients treated with prasugrel at the doses (loading/maintenance doses: 20/3.75 mg) adjusted for Japanese patients, evaluate the risk factors for bleeding in Japanese patients, and examine whether patients with a bleeding event are at increased risk of recurrent bleeding. This review covers published data and new analyses of the PRASFIT (PRASugrel compared with clopidogrel For Japanese patIenTs) trials of patients undergoing PCI for acute coronary syndrome or elective reasons. The bleeding risk with prasugrel was similar to that observed with the standard dose of clopidogrel (300/75 mg), including when bleeding events were re-classified using the Bleeding Academic Research Consortium criteria. The pharmacodynamics of prasugrel was not associated with the risk of bleeding events. The main risk factors for bleeding events were female sex, low body weight, advanced age, and presence of diabetes mellitus. Use of a radial puncture site was associated with a lower risk of bleeding during PCI than a femoral puncture site. Finally, the frequency and severity of recurrent bleeding events during continued treatment were similar between prasugrel and clopidogrel. In summary, this review provides important insights into the risk and types of bleeding events in prasugrel-treated patients.

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Relationship between post‐treatment platelet reactivity and ischemic and bleeding events at 1‐year follow‐up in patients receiving prasugrel

Abstract: confidence interval [CI]: 1.2-1.72; P < 0.001 and OR: 0.75, 95% CI: 0.59-0.96; P = 0.024 [respectively, per 10% increase]). Conclusion: Platelet reactivity measurement after a prasugrel LD predicts both ischemic and bleeding events at 1 year follow-up for ACS patients undergoing PCI.

Cited by 121 publications

References 26 publications

Comparison of Prasugrel and Ticagrelor Antiplatelet Effects in Korean Patients Presenting With ST-Segment Elevation Myocardial Infarction

Comparison of Prasugrel and Ticagrelor Antiplatelet Effects in Korean Patients Presenting With ST-Segment Elevation Myocardial Infarction

Validation of a New ELISA-Based Vasodilator-Associated Stimulated Phosphoprotein Phosphorylation Assay to Assess Platelet Reactivity Index in a Chinese Population

Risk of bleeding and repeated bleeding events in prasugrel-treated patients: a review of data from the Japanese PRASFIT studies

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