Comparative evaluation of standard maintenance-dose clopidogrel versus low-dose prasugrel in patients with stable coronary artery disease after percutaneous coronary intervention.
| Autor: | Akimaru K; Nagoya Tokushukai General Hospital, Aichi, Japan., Iwabuchi M; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Electronic address: masas258@med.u-ryukyu.ac.jp., Ishida A; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Uehara H; Urasoe General Hospital, Okinawa, Japan., Higa N; Naha City Hospital, Okinawa, Japan., Kakazu M; Tomishiro Central Hospital, Okinawa, Japan., Wake M; Okinawa Prefectural Chubu Hospital, Okinawa, Japan., Maeda T; Ohama Daiichi Hospital, Okinawa, Japan., Maeda T; Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan., Arima H; Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan., Ohya Y; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Tokashiki S; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Wakugawa H; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Miyagi A; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Shiohira S; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Zaima S; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Shiohira T; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Toma Y; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan., Ikemiyagi H; Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. |
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| Jazyk: | angličtina |
| Zdroj: | International journal of cardiology [Int J Cardiol] 2022 Jun 01; Vol. 356, pp. 30-35. Date of Electronic Publication: 2022 Feb 19. |
| DOI: | 10.1016/j.ijcard.2022.02.023 |
| Abstrakt: | Background: Treatment with low-dose prasugrel might be more beneficial even in chronic stable coronary artery disease (CAD) patients treated with clopidogrel. We compared platelet reactivity between standard maintenance-dose and low-dose prasugrel in stable CAD patients. Methods: This multicenter study enrolled 164 stable CAD patients receiving dual antiplatelet therapy with aspirin and clopidogrel. Patients were randomly assigned to continue treatment with 75-mg clopidogrel daily (n = 80) or switch to 3.75-mg prasugrel daily (n = 84). Platelet reactivity was evaluated by measuring P2Y Results: The PRU level was comparable between the two groups at baseline but was significantly lower in the prasugrel group than in the clopidogrel group on days 5 (133.0 vs. 156.8 PRU, P = 0.005) and 30 (124.3 vs. 158.0 PRU, P < 0.001). On day 30, the PRU level was lower in the prasugrel group among patients categorized as poor and intermediate metabolizers but not among extensive metabolizers. Conclusions: Low-dose prasugrel achieves more consistent antiplatelet effects than clopidogrel irrespective of the metabolic phenotype in Japanese patients with stable CAD. Low-dose prasugrel might be also beneficial in the chronic phase without increasing the bleeding risk among stable CAD patients in other countries. (Copyright © 2022. Published by Elsevier B.V.) |
| Databáze: | MEDLINE |
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