P2Y(12) receptor inhibition with prasugrel and ticagrelor in STEMI patients after fibrinolytic therapy: Analysis from the SAMPA randomized trial

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dc.citation.volume230
dc.contributor.authorGuimaraes, Leonardo de F. C. [UNIFESP]
dc.contributor.authorGenereux, Philippe
dc.contributor.authorSilveira, Diego [UNIFESP]
dc.contributor.authorPesaro, Antonio Eduardo
dc.contributor.authorFalcao, Felipe [UNIFESP]
dc.contributor.authorBarbosa, Bruno Robalinho C. [UNIFESP]
dc.contributor.authorde Souza, Cristiano Freitas [UNIFESP]
dc.contributor.authorFonseca, Francisco A. H. [UNIFESP]
dc.contributor.authorRodrigues Alves, Claudia Maria [UNIFESP]
dc.contributor.authorde Camargo Carvalho, Antonio Carlos [UNIFESP]
dc.contributor.authorStone, Gregg W.
dc.contributor.authorCaixeta, Adriano [UNIFESP]
dc.coverageClare
dc.date.accessioned2020-07-17T14:02:49Z
dc.date.available2020-07-17T14:02:49Z
dc.date.issued2017
dc.description.abstractBackground: A pharmacodynamic comparison between ticagrelor and prasugrel after fibrinolytic therapy has not yet been performed. Methods: In the single-center SAMPA trial, 50 consecutive STEMI patients previously treated with clopidogrel and undergoing a pharmacoinvasive strategy were randomized to either a ticagrelor (n= 25) 180 mg loading dose followed by 90 mg bid, or a prasugrel (n - 25) 60 mg loading dose followed by 10 mg/day, initiated after fibrinolytic therapy but before angiography. Platelet reactivity was assessed with the Verify Now P2Y(12) assay at 0, 2, 6, and 24 h after randomization. Results: Mean times from fibrinolysis to prasugrel or ticagrelor administration were 11.1 +/- 6.9 and 13.3 +/- 6.3 h, respectively (p= 0.24). The values of PRUdecreased significantly from baseline to 2 h (all p < 0.001) and from2 h to 6 h (all p < 0.001) in both groups. There was no difference in PRU values between 6 h and 24 h. The mean PRU values at 0, 2, 6, and 24 h were 234.9, 127.8, 45.4, and 48.0 in the prasugrel group and 233.1, 135.1, 67.7, and 56.9 in the ticagrelor group, respectively. PRU values did not significantly differ between groups at any time period of the study. Conclusions: In patients with STEMI treated with fibrinolytic therapy, platelet inhibition after clopidogrel is suboptimal and can be further increased with more potent agents. Ticagrelor and prasugrel demonstrated a similar extent of P2Y12 receptor inhibition within 24 h, although maximal platelet inhibition after these potent agents was not achieved for 6 h. (C) 2016 Elsevier Ireland Ltd. All rights reserved.en
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Rua Napoleao de Barros 715, BR-04024002 Sao Paulo, Brazil
dc.description.affiliationCardiovasc Res Fdn, Clin Trials Ctr, New York, NY USA
dc.description.affiliationColumbia Univ, Med Ctr, New York Presbyterian Hosp, New York, NY USA
dc.description.affiliationUniv Montreal, Hop Sacre Coeur Montreal, Montreal, PQ, Canada
dc.description.affiliationMorristown Med Ctr, Morristown, NJ USA
dc.description.affiliationHosp Israelita Albert Einstein, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Rua Napoleao de Barros 715, BR-04024002 Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent204-208
dc.identifierhttp://dx.doi.org/10.1016/j.ijcard.2016.12.173
dc.identifier.citationInternational Journal Of Cardiology. Clare, v. 230, p. 204-208, 2017.
dc.identifier.doi10.1016/j.ijcard.2016.12.173
dc.identifier.issn0167-5273
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55048
dc.identifier.wosWOS:000397904000034
dc.language.isoeng
dc.publisherElsevier Ireland Ltd
dc.relation.ispartofInternational Journal Of Cardiology
dc.rightsAcesso restrito
dc.subjectTicagreloren
dc.subjectPrasugrelen
dc.subjectFibrinolysisen
dc.subjectAcute myocardial infarctionen
dc.titleP2Y(12) receptor inhibition with prasugrel and ticagrelor in STEMI patients after fibrinolytic therapy: Analysis from the SAMPA randomized trialen
dc.typeArtigo
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