Pharmacodynamic assessment of a novel P2Y12 receptor antagonist in Japanese patients with coronary artery disease undergoing elective percutaneous coronary intervention

Thrombosis Research, 05/01/2012

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.

Results

  • 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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