| Autor: |
Vogel, Rosanne F. Delewi, Ronak Angiolillo, Dominick J. and Wilschut, Jeroen M. Lemmert, Miguel E. Diletti, Roberto van Vliet, Ria van der Waarden, Nancy W. P. L. Nuis, Rutger-Jan and Paradies, Valeria Alexopoulos, Dimitrios Zijlstra, Felix and Montalescot, Gilles Krucoff, Mitchell W. van Mieghem, Nicolas M. and Smits, Pieter C. Vlachojannis, Georgios J. |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Popis: |
OBJECTIVES This study sought to compare the pharmacodynamic effects of pre-hospitally administered P2Y(12) inhibitor prasugrel in crushed versus integral tablet formulation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). BACKGROUND Early dual antiplatelet therapy is recommended in STEMI patients. Yet, onset of oral P2Y(12) inhibitor effect is delayed and varies according to formulation administered. METHODS The COMPARE CRUSH (Comparison of Pre-hospital Crushed Versus Uncrushed Prasugrel Tablets in Patients With STEMI Undergoing Primary Percutaneous Coronary Interventions) trial randomized patients with suspected STEMI to crushed or integral prasugrel 60-mg loading dose in the ambulance. Pharmacodynamic measurements were performed at 4 time points: before antiplatelet treatment, at the beginning and end of pPCI, and 4 h after study treatment onset. The primary endpoint was high platelet reactivity at the end of pPCI. The secondary endpoint was impact of platelet reactivity status on markers of coronary reperfusion. RESULTS A total of 441 patients were included. In patients with crushed prasugrel, the occurrence of high platelet reactivity at the end of pPCI was reduced by almost one-half (crushed 34.7% vs. uncrushed 61.6%; odds ratio [OR] = 0.33; 95% confidence interval [CI] = 0.22 to 0.50; p < 0.01). Platelet reactivity |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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