Impact of immature platelets on platelet response to ticagrelor and prasugrel in patients with acute coronary syndrome
| Autor: | Alexander Goedel, Adnan Kastrati, Isabell Bernlochner, Karl-Ludwig Laugwitz, Wolfgang Siess, Stefanie Schüpke, Heribert Schunkert, Christoph Schulz, Tanja Morath, Katharina Mayer, Bernhard Haller, Conny Plischke, Siegmund Braun |
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| Rok vydání: | 2015 |
| Předmět: |
Blood Platelets
Male Ticagrelor medicine.medical_specialty Acute coronary syndrome Adenosine Prasugrel Platelet Aggregation P-selectin Immature Platelet Gastroenterology chemistry.chemical_compound P2Y12 Internal medicine medicine Humans Platelet Prospective Studies Acute Coronary Syndrome Aged business.industry medicine.disease ddc Hospitalization P-Selectin Adenosine diphosphate Treatment Outcome chemistry Anesthesia Purinergic P2Y Receptor Antagonists Female Cardiology and Cardiovascular Medicine business Prasugrel Hydrochloride Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | European Heart Journal. 36:3202-3210 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehv326 |
| Popis: | AIMS The influence of reticulated platelets (RPs) on platelet inhibition by ticagrelor when compared with prasugrel is unknown. We aimed to determine the influence of RPs on adenosine diphosphate- (ADP-) induced platelet aggregation in patients with acute coronary syndrome who were randomly assigned to receive either ticagrelor or prasugrel for P2Y12 receptor inhibition. METHODS AND RESULTS One hundred and twenty-four patients were prospectively enrolled. The immature platelet fraction (IPF) was measured by an automated haematoanalyzer and platelet aggregation was assessed by multiple electrode aggregometry. In a subgroup of patients (n = 28) ADP-induced P-selectin expression was measured in dependence of the time point of study drug intake in RPs that were discriminated from mature platelets by thiazole-orange (TO) staining. The primary endpoint was the correlation of platelet aggregation and IPF in ticagrelor- vs. prasugrel-treated patients. Platelet aggregation significantly correlated with IPF in patients who received prasugrel (r = 0.41, P < 0.001). In contrast, no correlation between IPF and platelet aggregation was observed in ticagrelor-treated patients (r = 0.08, P = 0.51, P for difference of correlation coefficients P = 0.05). Within the TO-positive RP fraction, P-selectin expression was significantly higher in prasugrel when compared with ticagrelor-treated individuals (prasugrel 18.6 ± 16.0% vs. ticagrelor 11.5 ± 6.0%, P = 0.047). A time-dependent P-selectin expression was observed in prasugrel but not in ticagrelor-treated patients (prasugrel early 11.9 ± 9.4% vs. late 26.3 ± 19.0%, P = 0.031, ticagrelor early 9.6 ± 4.9% vs. late 13.5 ± 6.6%, P = 0.127). CONCLUSION Reticulated platelets show a greater impact on platelet reactivity in response to prasugrel when compared with ticagrelor. |
| Databáze: | OpenAIRE |
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