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dc.contributor.authorWiviott, Stephen D.
dc.contributor.authorTrenk, Dietmar
dc.contributor.authorFrelinger, Andrew L. III
dc.contributor.authorO'Donoghue, Michelle
dc.contributor.authorNeumann, Franz-Josef
dc.contributor.authorMichelson, Alan D.
dc.contributor.authorAngiolillo, Dominick J.
dc.contributor.authorHod, Hanoch
dc.contributor.authorMontalescot, Gilles
dc.contributor.authorMiller, Debra L.
dc.contributor.authorJakubowski, Joseph A.
dc.contributor.authorCairns, Richard
dc.contributor.authorMurphy, Sabina A.
dc.contributor.authorMcCabe, Carolyn H.
dc.contributor.authorAntman, Elliott M.
dc.contributor.authorBraunwald, Eugene
dc.date2022-08-11T08:10:11.000
dc.date.accessioned2022-08-23T16:58:38Z
dc.date.available2022-08-23T16:58:38Z
dc.date.issued2007-12-18
dc.date.submitted2012-04-25
dc.identifier.citationCirculation. 2007 Dec 18;116(25):2923-32. Epub 2007 Dec 3. doi: 10.1161/CIRCULATIONAHA.107.740324
dc.identifier.issn0009-7322 (Linking)
dc.identifier.doi10.1161/CIRCULATIONAHA.107.740324
dc.identifier.pmid18056526
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43413
dc.description.abstractBACKGROUND: The increasing use of higher-than-approved doses of clopidogrel in clinical practice is based in part on the desire for greater levels of inhibition of platelet aggregation (IPA). Prasugrel is a new thienopyridine that is more potent than standard-dose clopidogrel in healthy subjects and patients with stable coronary artery disease. The relative antiplatelet effects of prasugrel versus high-dose clopidogrel in percutaneous coronary intervention patients are unknown. METHODS AND RESULTS: Prasugrel in Comparison to Clopidogrel for Inhibition of Platelet Activation and Aggregation-Thrombolysis in Myocardial Infarction 44 (PRINCIPLE-TIMI 44) was a randomized, double-blind, 2-phase crossover study of prasugrel compared with high-dose clopidogrel in patients undergoing cardiac catheterization for planned percutaneous coronary intervention. The primary end point of the loading-dose phase (prasugrel 60 mg versus clopidogrel 600 mg) was IPA with 20 mumol/L ADP at 6 hours. Patients with percutaneous coronary intervention entered the maintenance-dose phase, a 28-day crossover comparison of prasugrel 10 mg/d versus clopidogrel 150 mg/d with a primary end point of IPA after 14 days of either drug. In this study, 201 subjects were randomized. IPA at 6 hours was significantly higher in subjects receiving prasugrel (mean+/-SD, 74.8+/-13.0%) compared with clopidogrel (31.8+/-21.1%; Pandlt;0.0001). During the maintenance-dose phase, IPA with 20 mumol/L ADP was higher in subjects receiving prasugrel (61.3+/-17.8%) compared with clopidogrel (46.1+/-21.3%; Pandlt;0.0001). Results were consistent across all key secondary end points; significant differences emerged by 30 minutes and persisted across all time points. CONCLUSIONS: Among patients undergoing cardiac catheterization with planned percutaneous coronary intervention, loading with 60 mg prasugrel resulted in greater platelet inhibition than a 600-mg clopidogrel loading dose. Maintenance therapy with prasugrel 10 mg/d resulted in a greater antiplatelet effect than 150 mg/d clopidogrel.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=18056526&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1161/CIRCULATIONAHA.107.740324
dc.subjectAged
dc.subjectAngioplasty, Balloon, Coronary
dc.subjectCombined Modality Therapy
dc.subjectCross-Over Studies
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectPiperazines
dc.subjectPlatelet Activation
dc.subjectPlatelet Aggregation Inhibitors
dc.subjectThiophenes
dc.subjectThrombolytic Therapy
dc.subjectTiclopidine
dc.subjectderivatives
dc.subjectTreatment Outcome
dc.subjectHematology
dc.subjectOncology
dc.subjectPediatrics
dc.titlePrasugrel compared with high loading- and maintenance-dose clopidogrel in patients with planned percutaneous coronary intervention: the Prasugrel in Comparison to Clopidogrel for Inhibition of Platelet Activation and Aggregation-Thrombolysis in Myocardial Infarction 44 trial
dc.typeJournal Article
dc.source.journaltitleCirculation
dc.source.volume116
dc.source.issue25
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/peds_hematology/90
dc.identifier.contextkey2796580
html.description.abstract<p>BACKGROUND: The increasing use of higher-than-approved doses of clopidogrel in clinical practice is based in part on the desire for greater levels of inhibition of platelet aggregation (IPA). Prasugrel is a new thienopyridine that is more potent than standard-dose clopidogrel in healthy subjects and patients with stable coronary artery disease. The relative antiplatelet effects of prasugrel versus high-dose clopidogrel in percutaneous coronary intervention patients are unknown.</p> <p>METHODS AND RESULTS: Prasugrel in Comparison to Clopidogrel for Inhibition of Platelet Activation and Aggregation-Thrombolysis in Myocardial Infarction 44 (PRINCIPLE-TIMI 44) was a randomized, double-blind, 2-phase crossover study of prasugrel compared with high-dose clopidogrel in patients undergoing cardiac catheterization for planned percutaneous coronary intervention. The primary end point of the loading-dose phase (prasugrel 60 mg versus clopidogrel 600 mg) was IPA with 20 mumol/L ADP at 6 hours. Patients with percutaneous coronary intervention entered the maintenance-dose phase, a 28-day crossover comparison of prasugrel 10 mg/d versus clopidogrel 150 mg/d with a primary end point of IPA after 14 days of either drug. In this study, 201 subjects were randomized. IPA at 6 hours was significantly higher in subjects receiving prasugrel (mean+/-SD, 74.8+/-13.0%) compared with clopidogrel (31.8+/-21.1%; Pandlt;0.0001). During the maintenance-dose phase, IPA with 20 mumol/L ADP was higher in subjects receiving prasugrel (61.3+/-17.8%) compared with clopidogrel (46.1+/-21.3%; Pandlt;0.0001). Results were consistent across all key secondary end points; significant differences emerged by 30 minutes and persisted across all time points.</p> <p>CONCLUSIONS: Among patients undergoing cardiac catheterization with planned percutaneous coronary intervention, loading with 60 mg prasugrel resulted in greater platelet inhibition than a 600-mg clopidogrel loading dose. Maintenance therapy with prasugrel 10 mg/d resulted in a greater antiplatelet effect than 150 mg/d clopidogrel.</p>
dc.identifier.submissionpathpeds_hematology/90
dc.contributor.departmentDepartment of Pediatrics
dc.source.pages2923-32


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