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Prasugrel

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https://www.readbyqxmd.com/read/28745582/cyp2c19-guided-antiplatelet-therapy-a-cost-effectiveness-analysis-of-30-day-and-1-year-outcomes-following-percutaneous-coronary-intervention
#1
Mrudula S Borse, Olivia M Dong, Melissa J Polasek, Joel F Farley, George A Stouffer, Craig R Lee
AIM: Determine whether using CYP2C19 genotype to optimize antiplatelet therapy selection is cost-effective over the initial 30 days and 1-year following percutaneous coronary intervention. MATERIALS & METHODS: A cost-effectiveness analysis compared 30-day and 1-year outcomes and cost across three treatment strategies (universal clopidogrel, universal prasugrel, genotype-guided) in a hypothetical cohort. RESULTS: Base-case scenario results at 30 days indicated that the incremental cost per major cardiovascular or bleeding event avoided for genotype-guided treatment was US$8525 and US$42,198 compared with universal clopidogrel and prasugrel, respectively...
July 26, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28743191/successful-utilization-of-an-electronic-pain-diary-in-a-multinational-phase-3-interventional-study-of-pediatric-sickle-cell-anemia
#2
Lori E Heath, Matthew M Heeney, Carolyn C Hoppe, Samuel Adjei, Tsiri Agbenyega, Mohamed Badr, Nicoletta Masera, Chunmei Zhou, Patricia B Brown, Joseph A Jakubowski, Carlton Dampier
BACKGROUND/AIMS: Patients with sickle cell anemia can experience recurrent pain episodes, which affect quality of life. The reported prevalence of pain is higher in studies using patient diaries than in healthcare facility utilization data. Determining Effects of Platelet Inhibition on Vaso-Occlusive Events was a multinational study that assessed the efficacy and safety of prasugrel in reducing the rate of vaso-occlusive events in children with sickle cell anemia (NCT01794000) and included an electronic patient-reported outcome diary to record pain occurrence...
July 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#3
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#4
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28710684/utility-of-physiologically-based-pharmacokinetic-absorption-modeling-to-predict-the-impact-of-salt-to-base-conversion-on-prasugrel-hcl-product-bioequivalence-in-the-presence-of-proton-pump-inhibitors
#5
Jianghong Fan, Xinyuan Zhang, Liang Zhao
Prasugrel HCl may convert to prasugrel base during manufacturing or storage. It was reported that formulations with different ratios of salt to base were bioequivalent in healthy subjects, but formulations with a higher extent of conversion were not bioequivalent in subjects taking proton pump inhibitor (PPI) whose stomach pH is elevated. The objective of this study was to assess the magnitude of impact of salt-to-base conversion on prasugrel HCl products BE evaluation in healthy subjects on PPI. A physiologically based pharmacokinetic (PBPK) absorption model was constructed to predict pharmacokinetic (PK) profiles of active metabolite after oral administration of prasugrel HCl products containing various fractions of base based on the prasugrel salt and base intrinsic solubility...
July 14, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28709700/prasugrel-as-opposed-to-clopidogrel-improves-endothelial-nitric-oxide-bioavailability-and-reduces-platelet-leukocyte-interaction-in-patients-with-unstable-angina-pectoris-a-randomized-controlled-trial
#6
Tanja K Rudolph, Alexander Fuchs, Anna Klinke, Andrea Schlichting, Kai Friedrichs, Martin Hellmich, Martin Mollenhauer, Edzard Schwedhelm, Stephan Baldus, Volker Rudolph
BACKGROUND: Platelet inhibition has been linked to improved endothelial function, a prognostic factor in coronary artery disease. Whether prasugrel, a potent platelet inhibitor, affects endothelial function remains unknown. METHODS: This was a double-blind, randomized, active-controlled, parallel trial. Patients with unstable angina pectoris undergoing percutaneous coronary intervention (PCI) received either a daily dose of clopidogrel 75mg (n=23) or prasugrel 10mg (n=22)...
July 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28707295/repetitive-stent-thrombosis-in-a-patient-with-suspected-allergy-to-aspirin-and-multiple-switch-between-clopidogrel-prasugrel-and-ticagrelor
#7
Bogumił Ramotowski, Anna Żuk, Andrzej Budaj
No abstract text is available yet for this article.
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28692105/prasugrel-in-critically-ill-patients
#8
Christian Schoergenhofer, Eva-Luise Hobl, Thomas Staudinger, Walter S Speidl, Gottfried Heinz, Jolanta Siller-Matula, Christian Zauner, Birgit Reiter, Jacek Kubica, Bernd Jilma
While prasugrel is indicated for the treatment of myocardial infarction, its effects in the most severely affected patients requiring intensive care is unknown, so that we measured the antiplatelet effects and sparse pharmacokinetics of prasugrel in critically ill patients. Twenty-three patients admitted to medical intensive care units, who were treated with 10 mg prasugrel once daily, were included in this prospective trial. Critically ill patients responded poorly to daily prasugrel treatment: adenosine diphosphate (ADP)-induced aggregation in whole blood classified 65 % (95 % confidence intervals (CI) 43-84 %) of patients as having high on treatment platelet reactivity, platelet function under high shear rates even 74 % (95 %CI 52-90 %)...
July 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28689434/role-of-genetic-testing-in-patients-undergoing-percutaneous-coronary-intervention
#9
Jae Youn Moon, Francesco Franchi, Fabiana Rollini, Jose R Rivas Rios, Megha Kureti, Larisa H Cavallari, Dominick J Angiolillo
Variability in individual response profiles to antiplatelet therapy, in particular clopidogrel, is a well-established phenomenon. Genetic variations of the cytochrome P450 (CYP) 2C19 enzyme, a key determinant in clopidogrel metabolism, have been associated with clopidogrel response profiles. Moreover, the presence of a CYP2C19 loss-of-function allele is associated with an increased risk of atherothrombotic events among clopidogrel-treated patients undergoing percutaneous coronary interventions (PCI), prompting studies evaluating the use of genetic tests to identify patients who may be potential candidates for alternative platelet P2Y12 receptor inhibiting therapies (prasugrel or ticagrelor)...
July 10, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28685204/time-course-of-the-antiplatelet-effect-after-switching-to-clopidogrel-from-initial-prasugrel-therapy-in-patients-with-acute-coronary-syndrome
#10
Erito Furuse, Hitoshi Takano, Takeshi Yamamoto, Yoshiaki Kubota, Takashi Yoshizane, Mitsunobu Kitamura, Hideki Miyachi, Yusuke Hosokawa, Wataru Shimizu
Prasugrel is often replaced with clopidogrel after a certain period of time following coronary stenting. However, the time course of platelet aggregation during this replacement is unknown. We performed a prospective, single-arm study to monitor platelet reactivity before and after the replacement. Forty-five patients (mean age 62.6 ± 13 years, 40 male) who received coronary stenting for acute coronary syndrome were initially treated with the loading dose (20 mg) of prasugrel followed by the maintenance dose (3...
July 6, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28681220/comparison-of-platelet-aggregation-response-in-switching-regimen-from-prasugrel-to-clopidogrel-between-cyp2c19-extensive-versus-non-extensive-metabolizers
#11
Soichiro Ebisawa, Yasushi Ueki, Tomoaki Mochidome, Keisuke Senda, Hitoshi Nishimura, Tatsuya Saigusa, Takashi Miura, Hirohiko Motoki, Jun Koyama, Uichi Ikeda
Little is known about the response of platelet aggregation in patients with acute coronary syndrome (ACS) when prasugrel is changed to clopidogrel. In this study, we evaluated the pharmacodynamic effects of this medication switch. Twenty-one consecutive ACS patients received prasugrel 20 mg as a loading dose before emergent percutaneous coronary intervention and 3.75 mg as a maintenance dose on days 2-7 (prasugrel phase). From day 8, prasugrel was switched to clopidogrel 75 mg/day (clopidogrel phase). P2Y12 reaction units (PRU) were measured 2-4 h after prasugrel loading, and on days 7, 11, 13, 15, and 42...
July 5, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28675986/clinical-determinants-of-clopidogrel-responsiveness-in-a-heterogeneous-cohort-of-puerto-rican-hispanics
#12
Dagmar F Hernandez-Suarez, Stuart A Scott, Matthew I Tomey, Kyle Melin, Angel Lopez-Candales, Charlotte E Buckley, Jorge Duconge
BACKGROUND: Clopidogrel is by far the most prescribed platelet adenosine diphosphate (ADP) antagonist in Puerto Rico despite the advent of newer agents (prasugrel and ticagrelor). Given the paucity of data on clopidogrel responsiveness in Hispanics, we sought to determine the association between clinical characteristics and platelet reactivity in Puerto Rican patients on clopidogrel therapy. STUDY POPULATION: A total of 100 Puerto Rican patients on clopidogrel therapy were enrolled and allocated into two groups: Group I, without high on-treatment platelet reactivity (HTPR); and Group II, with HTPR...
July 1, 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/28675527/rumpel-leede-phenomenon-in-a-patient-being-treated-with-prasugrel
#13
Aaron E Pritchard, Evelyn L Lockhart
No abstract text is available yet for this article.
July 2017: Transfusion
https://www.readbyqxmd.com/read/28673508/comparison-of-prasugrel-versus-clopidogrel-in-korean-patients-with-acute-myocardial-infarction-undergoing-successful-revascularization
#14
Keun-Ho Park, Myung Ho Jeong, Hyun Kuk Kim, Tae Hoon Ahn, Ki Bae Seung, Dong Joo Oh, Dong-Joo Choi, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyung Kuk Hwang, Shung Chull Chae, Kwon-Bae Kim, Young Jo Kim, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae
BACKGROUND: Although there have been several reports that prasugrel can improve clinical outcomes, the efficacy and safety of prasugrel is unknown in Korean patients with acute myocardial infarction (AMI) undergoing successful revascularization. METHODS: A total of 4421 patients [637 patients were prescribed prasugrel (60/10 or 5mg, loading/maintenance dose) and 3784 patients clopidogrel (600 or 300/75mg)] with AMI undergoing successful revascularization were enrolled from the core clinical cohort of Korea Acute Myocardial Infarction Registry-National Institute of Health...
June 30, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28663045/appropriateness-assessment-in-antiplatelet-therapy-apathy-registry-insight-from-current-clinical-practice
#15
Nazario Carrabba, Benedetta Bellandi, Guido Parodi, Emanuele Cecchi, Giorgio Baldereschi, Cristina Giglioli, Angela Migliorini, Renato Valenti, Serafina Valente, Rossella Marcucci, Niccolò Marchionni, David Antoniucci
BACKGROUND: In clinical practice there is a gap between guidelines recommendation and antiplatelet strategies used for acute coronary syndrome (ACS). We sought to evaluate appropriateness of antiplatelet strategies employed in a tertiary center. METHODS AND RESULTS: From January to June 2014, 430 ACS were treated with percutaneous coronary intervention by 3 groups of interventional cardiologists. Aspirin and clopidogrel (52%) were the most commonly used antiplatelet therapies, being prasugrel associated with aspirin in 110 (25...
June 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28653184/reversal-of-the-platelet-inhibitory-effect-of-the-p2y12-inhibitors-clopidogrel-prasugrel-and-ticagrelor-in-vitro-a-new-approach-to-an-old-issue
#16
Lisa Schoener, Stefanie Jellinghaus, Bernhardt Richter, Christian Pfluecke, Georg Ende, Marian Christoph, Silvio Quick, Tobias Loehn, Uwe Speiser, David M Poitz, Johannes Mierke, Ruth H Strasser, Karim Ibrahim
AIM: Platelet transfusion is an effective option to reverse platelet inhibition in thienopyridine-treated patients suffering from bleedings or requiring urgent surgery. However, in ticagrelor-treated patients, the previous studies revealed significant clinical effects to platelet rich plasma (PRP) but poor response to pooled platelets (PP) as used in clinical routine. The aim of this study was to elucidate a potential pathomechanism to explain the poor response of ticagrelor to PP. METHODS AND RESULTS: From 79 whole blood samples of patients treated with ticagrelor, prasugrel, or clopidogrel, the PRI-VASP was determined before and after in vitro platelet supplementation of PP or PRP at increasing concentrations...
June 26, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28645644/-antiplatelet-agents-and-transfusion
#17
P Gaussem, A-C Martin, T Belleville-Rolland, D Helley, C Bachelot-Loza, A Godier
Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties...
June 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#18
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28625369/rationale-and-design-of-the-hunting-for-the-off-target-properties-of-ticagrelor-on-endothelial-function-and-other-circulating-biomarkers-in-humans-hi-tech-trial
#19
Sara Ariotti, Maarten van Leeuwen, Salvatore Brugaletta, Sergio Leonardi, Kristiaan Martijn Akkerhuis, Emrush Rexhaj, Gladys Janssens, Luis Ortega-Paz, Diego Rizzotti, Jan C van den Berge, Dierik Heg, Gloria Francolini, Stephan Windecker, Marco Valgimigli
BACKGROUND: Among the 3 approved oral P2Y12 inhibitors for the treatment for patients with acute coronary syndrome (ACS), ticagrelor, but not prasugrel or clopidogrel, has been associated with off-target properties, such as improved endothelial-dependent vasomotion and increased adenosine plasma levels. METHODS: The HI-TECH study (NCT02587260) is a multinational, randomized, open-label, crossover study with a Latin squares design, conducted at 5 European sites, in which patients free from recurrent ischemic or bleeding events ≥30 days after a qualifying ACS were allocated to sequentially receive a 30 ± 5-day treatment with prasugrel, clopidogrel, and ticagrelor in random order...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619235/morphological-and-pharmacological-determinants-of-peri-procedural-myocardial-infarction-following-elective-stent-implantation-optical-coherence-tomography-sub-analysis-of-the-prasfit-elective-study
#20
Kenzo Uzu, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Tsuyoshi Osue, Masamichi Iwasaki, Hiroto Kinutani, Akihide Konishi, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Ken-Ichi Hirata, Shigeru Saito, Masato Nakamura, Junya Shite, Takashi Akasaka
BACKGROUND: Previous studies have suggested that peri-procedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) is associated with adverse short- and long-term outcomes, and several morphological predictors of PMI have been studied. However, the determinants of PMI under novel anti-platelet therapy are not fully elucidated. METHODS AND RESULTS: PRASFIT-Elective is a multicenter, parallel-group study of PCI patients in non-acute settings receiving either prasugrel or clopidogrel in addition to aspirin...
June 12, 2017: Journal of Cardiology
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