Pharmacodynamic Effects of Switching From Ticagrelor to Clopidogrel in Patients With Coronary Artery Disease: Results of the SWAP-4 Study.
Autor: | Franchi F; University of Florida College of Medicine-Jacksonville., Rollini F; University of Florida College of Medicine-Jacksonville., Rivas Rios J; University of Florida College of Medicine-Jacksonville., Rivas A; University of Florida College of Medicine-Jacksonville., Agarwal M; University of Florida College of Medicine-Jacksonville., Kureti M; University of Florida College of Medicine-Jacksonville., Nagaraju D; University of Florida College of Medicine-Jacksonville., Wali M; University of Florida College of Medicine-Jacksonville., Shaikh Z; University of Florida College of Medicine-Jacksonville., Briceno M; University of Florida College of Medicine-Jacksonville., Nawaz A; University of Florida College of Medicine-Jacksonville., Moon JY; University of Florida College of Medicine-Jacksonville., Been L; University of Florida College of Medicine-Jacksonville., Suryadevara S; University of Florida College of Medicine-Jacksonville., Soffer D; University of Florida College of Medicine-Jacksonville., Zenni MM; University of Florida College of Medicine-Jacksonville., Bass TA; University of Florida College of Medicine-Jacksonville., Angiolillo DJ; University of Florida College of Medicine-Jacksonville. dominick.angiolillo@jax.ufl.edu. |
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Jazyk: | angličtina |
Zdroj: | Circulation [Circulation] 2018 Jun 05; Vol. 137 (23), pp. 2450-2462. Date of Electronic Publication: 2018 Mar 11. |
DOI: | 10.1161/CIRCULATIONAHA.118.033983 |
Abstrakt: | Background: Switching between different classes of P2Y Methods: This was a prospective, randomized, open-label study conducted in patients on maintenance dosing (MD) of aspirin (81 mg/d) and clopidogrel (75 mg/d). After a 7-day run-in with ticagrelor (180 mg loading dose [LD] followed by 90 mg twice daily MD), patients (n=80) were randomized into 1 of 4 groups: group A, clopidogrel 600 mg LD 24 hours after the last MD of ticagrelor (C-600 mg-24h); group B, clopidogrel 600 mg LD 12 hours after the last MD of ticagrelor (C-600 mg-12h); group C, clopidogrel 75 mg/d MD 24 hours after the last MD of ticagrelor (C-75 mg-24h); and group D, ticagrelor 90 mg twice daily MD (T-90 mg twice daily). MD of the randomized treatment was maintained for 10±3 days. Pharmacodynamic assessments were performed at baseline, after run-in, and at 2, 24, 48, and 72 hours and 10 days with P2Y Results: T-90 mg twice daily led to lower platelet reactivity than any clopidogrel regimen using all assays at all time points. P2Y Conclusions: De-escalation from ticagrelor to clopidogrel therapy is associated with an increase in platelet reactivity. The use of an LD before the initiation of an MD regimen of clopidogrel mitigates these observations, although this is not affected by the timing of its administration after ticagrelor discontinuation. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02287909. (© 2018 American Heart Association, Inc.) |
Databáze: | MEDLINE |
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