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

• Published in: Circulation Journal 2015/05/25, Vol.79(6), pp.1248-1254
• Main Authors: Lee, Young Seok, Jin, Cai De, Kim, Moo Hyun, Guo, Long Zhe, Cho, Young-Rak, Park, Kyungil, Park, Jong Sung, Park, Tae-Ho, Kim, Young Dae
• Format: Article
• Language: English
• Subjects: Adenosine - adverse effects; Adenosine - analogs & derivatives; Adenosine - pharmacology; Adenosine - therapeutic use; Adult; Aged; Asian Continental Ancestry Group; Aspirin - therapeutic use; Cardiac Catheterization; Double-Blind Method; Female; Hemorrhage - chemically induced; Humans; Korea; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - surgery; Percutaneous Coronary Intervention; Pilot Projects; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - pharmacology; Platelet Aggregation Inhibitors - therapeutic use; Platelet Function Tests; Platelet inhibition; Postoperative Complications - prevention & control; Prasugrel; Prasugrel Hydrochloride - adverse effects; Prasugrel Hydrochloride - pharmacology; Prasugrel Hydrochloride - therapeutic use; Prospective Studies; Purinergic P2Y Receptor Antagonists - adverse effects; Purinergic P2Y Receptor Antagonists - pharmacology; Purinergic P2Y Receptor Antagonists - therapeutic use; Republic of Korea; Sample Size; ST-segment elevation myocardial infarction; Thrombophilia - drug therapy; Thrombosis - prevention & control; Ticagrelor
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-15-0270

Background:There is insufficient data on the efficacy of prasugrel and ticagrelor in Korean patients with ST-segment elevation myocardial infarction (STEMI).Methods and Results:In the current double-blind, prospective pilot study, 39 patients with STEMI undergoing primary percutaneous coronary intervention were randomized to receive prasugrel 60 mg loading dose (LD) followed by 10 mg daily maintenance dose (n=19), or ticagrelor 180 mg LD followed by 90 mg twice daily maintenance dose (n=20). We assessed platelet reactivity with the VerifyNow and Vasodilator-Stimulated Phosphoprotein (VASP) P2Y12 assays. Compared to baseline platelet reactivity, both prasugrel and ticagrelor groups achieved similar and significantly lower P2Y12 reaction units (PRU) (259 [IQR: 230 to 281] vs. 28 [12 to 55] for prasugrel; 261 [196 to 286] vs. 43 [11 to 61] for ticagrelor), and platelet reactivity indexes (PRI) (51.2% [39.3 to 61.3] vs. 8.1% [6.1 to 14.7] for prasugrel; 47.5% [38.4 to 50.4] vs. 11.2% [7.1 to 15.5] for ticagrelor, all P values