Prasugrel switching from clopidogrel after percutaneous coronary intervention for acute coronary syndrome in Taiwanese patients: an analysis of safety and efficacy

The recommended maintenance dose of prasugrel for East Asian populations (i.e., Japanese and Taiwanese) is 3.75 mg as part of dual antiplatelet therapy (DAPT) for the prevention of recurrent ischemia and stent thrombosis in acute coronary syndrome (ACS). This modified dosage regimen has been establi...

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Published in:Cardiovascular intervention and therapeutics 2022-04, Vol.37 (2), p.269-278
Main Authors: Liu, Ping-Yen, Su, Cheng-Huang, Kuo, Feng-Yu, Lee, Wen-Lieng, Wang, Yi-Chih, Lin, Wei-Shiang, Chu, Pao-Hsien, Lu, Tse-Min, Lo, Ping-Han, Lee, Cheng-Han, Lan, Wei-Ren, Huang, Chien-Lung, Tsukiyama, Shuji, Yang, Wei-Chen, Cheng, Li-Chung, Rafael, Virginia, Nikolajsen, Christian, Yin, Wei-Hsian
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - drug therapy
Acute Coronary Syndrome - surgery
Aged
Cardiology
Clopidogrel - adverse effects
Female
Humans
Interventional Radiology
Male
Medicine
Medicine & Public Health
NCT
NCT03672097
Original
Original Article
Percutaneous Coronary Intervention - adverse effects
Platelet Aggregation Inhibitors - adverse effects
Prasugrel Hydrochloride - adverse effects
Ticlopidine - therapeutic use
Treatment Outcome
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Summary:The recommended maintenance dose of prasugrel for East Asian populations (i.e., Japanese and Taiwanese) is 3.75 mg as part of dual antiplatelet therapy (DAPT) for the prevention of recurrent ischemia and stent thrombosis in acute coronary syndrome (ACS). This modified dosage regimen has been established in studies conducted in Japan; however, the efficacy and safety of switching from clopidogrel to prasugrel DAPT among Taiwanese patients remain to be explored. In this phase IV, multicenter, single-arm, open-label study, we evaluated the 4-week pharmacodynamic response, and the 48-week safety outcomes of prasugrel 3.75 mg after a switch from clopidogrel in Taiwanese ACS patients. A total of 203 prasugrel-naïve ACS patients (over 90% male) who had received post-PCI clopidogrel DAPT for at least 2 weeks were enrolled from ten medical centers in Taiwan and subsequently switched to prasugrel 3.75 mg DAPT. Four weeks after the switch, P2Y12 reaction unit (PRU) values were significantly decreased in the total cohort (mean − 18.2 ± 48.1; 95% confidence interval − 24.9 to − 11.5, p   208) dropped from 23.5 to 10% ( p  
ISSN:1868-4300
1868-4297
1868-4297
DOI:10.1007/s12928-021-00771-w