Pharmacodynamic assessment of a novel P2Y12 receptor antagonist in Japanese patients with coronary artery disease undergoing elective percutaneous coronary intervention
Thrombosis Research, 05/01/2012Yoko H et al.
Prasugrel 15mg LD/3.75mg maintenance dose or higher doses was well tolerated and achieved a more rapid, higher and consistent antiplatelet effect than clopidogrel in Japanese coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI).
Eighty–four patients were randomized into four treatment groups: prasugrel 10/2.5mg (loading dose [LD]/maintenance dose [MD]), 15/3.75mg or 20/5mg, and clopidogrel 300/75mg.
The LD of each regimen was administered the day before PCI, followed by 28–day MD on aspirin background therapy (81–100mg).
Antiplatelet effects were evaluated by light transmission aggregometry and VASP assay.
The mean inhibition of platelet aggregation (IPA) induced by 20μM of adenosine diphosphate at 4hours after LD was higher among the prasugrel 10/2.5mg, 15/3.75mg and 20/5mg groups compared with the clopidogrel group (12.3%, 20.9%, 29.8% vs. 8.4%, respectively).
The proportion of subjects with an IPA of <10% on Day 28 was lower among the prasugrel 15/3.75mg, and 20/5mg groups than in the clopidogrel group (0%, 6.3% vs. 15.8%, respectively).
No “major” or “clinically relevant non–major” bleeding was observed.
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