image dons

je fais un don

Prasugrel compared with high-dose clopidogrel in acute coronary syndrome. The randomised, double-blind ACAPULCO study.

SAFA2022 (12-16 décembre) - Les experts répondent à vos questions
Trouble du rythme cardiaque responsable d'AVC - Dépistage gratuit et sans rdv !

Colloquium : Pathologies cardiaques de la femme (15 novembre 2022)
Replay prochainement disponible ici !!!

Prasugrel compared with high-dose clopidogrel in acute coronary syndrome. The randomised, double-blind ACAPULCO study.

Publié dans Thrombosis and Haemostasis, le 26 octobre 2009.

En savoir plus en consultant le site.

Auteurs : Montalescot G, Sideris G, Cohen R, Meuleman C, Bal dit Sollier C, Barthélémy O, Henry P, Lim P, Beygui F, Collet JP, Marshall D, Luo J, Petitjean H, Drouet L.

Abstract

Compared with the approved dose regimen of clopidogrel (300-mg loading dose [LD], 75-mg maintenance dose [MD]), prasugrel has been demonstrated to reduce ischaemic events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). In ACS, antiplatelet effects of a prasugrel MD regimen have not been previously compared with either a higher clopidogrel MD or after switching from a higher clopidogrel LD. The objective of this study was to evaluate the antiplatelet effect of a prasugrel 10-mg MD versus a clopidogrel 150-mg MD in patients with ACS who had received a clopidogrel 900-mg LD. Patients with non-ST elevation ACS, treated with aspirin and a clopidogrel 900-mg LD, were randomised within 24 hours post-LD to receive a prasugrel 10-mg or clopidogrel 150-mg MD. After 14 days of the initial MD, subjects switched to the alternative treatment for 14 days. The primary endpoint compared maximum platelet aggregation (MPA, 20 microM adenosine diphosphate [ADP]) between prasugrel and clopidogrel MDs for both periods. Responder analyses between treatments were performed using several platelet-function methods. Of 56 randomised subjects, 37 underwent PCI. MPA was 26.2% for prasugrel 10 mg and 39.1% for clopidogrel 150 mg (p<0.001). The prasugrel MD regimen reduced MPA from the post-900-mg LD level (41.2% to 29.1%, p=0.003). Poor response ranged from 0% to 6% for prasugrel 10 mg and 4% to 34% for clopidogrel 150 mg. Thus, in ACS patients a prasugrel 10-mg MD regimen resulted in significantly greater platelet inhibition than clopidogrel at twice its approved MD or a 900-mg LD.

Autres actualités

+

29/08/2022


Supraventricular arrhythmias more common than thought after...

Auteurs : Guedeney P, Laredo M, Zeitouni M, Hauguel-Moreau M, Wallet T, Elegamandji B, Alamowitch S, C...
+

10/09/2020


Culprit lesion location and outcomes in patients with multi-...

Publié dans EuroIntervention 2020 Sep 8: EIJ-D-20-00561. Auteurs : Hauguel-Moreau M, Barthélémy O, Farhan...
+

01/09/2020


COVID-19 acute myocarditis and Multisystem Inflammatory Synd...

Publié dans Chest 2020 Sep 7: S0012-3692(20)34359-2 Auteurs : Hékimian G, Kerneis M, Zeitouni M, Cohen-Au...