Yoko 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).Methods
- 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.