Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response: the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial

Nadia Paarup Dridi; Pär Ingemar Johansson; Peter Clemmensen; Trine Stissing; Maria Dumitrela Radu; Abbas Qayyum; Frants Pedersen; Steffen Helqvist; Kari Saunamäki; Henning Kelbæk; Erik Jørgensen; Thomas Engstrøm; Lene Holmvang

doi:10.3109/09537104.2013.845874

Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response: the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial

Nadia Paarup Dridi, Pär Ingemar Johansson, Peter Clemmensen, Trine Stissing, Maria Dumitrela Radu, Abbas Qayyum, Frants Pedersen, Steffen Helqvist, Kari Saunamäki, Henning Kelbæk, Erik Jørgensen, Thomas Engstrøm, Lene Holmvang

Institut for Klinisk Medicin

22 Citationer (Scopus)

Abstract

High on-treatment platelet reactivity (HTPR) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). The antiplatelet effect and safety of prasugrel was compared to that of double-dose clopidogrel in patients with stable coronary artery disease or acute coronary syndrome (ACS) exhibiting HTPR on clopidogrel and treated with PCI, using multiple electrode aggregometry (MEA) to assess platelet reactivity. Of 923 patients screened, 237 (25.7%) exhibited HTPR. Of these, 106 were eligible for participation in a randomized trial comparing two intensified antiplatelet regimen: 52 were assigned to double maintenance-dose clopidogrel and 54 to standard-dose prasugrel. At 1 month, tailoring antiplatelet therapy improved platelet inhibition to a level considered as therapeutic in 73.1% of patients. Prasugrel entailed greater platelet inhibition (p = 0.02) and a lower rate of persisting HTPR at follow-up compared to double-dose clopidogrel (HTPR persisted in 20.4% and 42% respectively, p = 0.02). Within the 30-day follow-up, no major bleeds were observed and the incidence of major adverse cardiovascular events (MACE) was similar in the two treatment arms. Prasugrel demonstrated superiority to double-dose clopidogrel in overcoming HTPR and reducing platelet activity. Intensifying antiplatelet therapy in both ACS and stable angina pectoris (SAP) patients exhibiting HTPR prior to PCI was well tolerated.

Originalsprog	Engelsk
Tidsskrift	Platelets
Vol/bind	25
Udgave nummer	7
Sider (fra-til)	506-512
Antal sider	7
ISSN	0953-7104
DOI	https://doi.org/10.3109/09537104.2013.845874
Status	Udgivet - 1 nov. 2014

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10.3109/09537104.2013.845874

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Citationsformater

Dridi, N. P., Johansson, P. I., Clemmensen, P., Stissing, T., Radu, M. D., Qayyum, A., Pedersen, F., Helqvist, S., Saunamäki, K., Kelbæk, H., Jørgensen, E., Engstrøm, T., & Holmvang, L. (2014). Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response: the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial. Platelets, 25(7), 506-512. https://doi.org/10.3109/09537104.2013.845874

Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response : the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial. / Dridi, Nadia Paarup; Johansson, Pär Ingemar; Clemmensen, Peter et al.

I: Platelets, Bind 25, Nr. 7, 01.11.2014, s. 506-512.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Dridi, NP, Johansson, PI, Clemmensen, P, Stissing, T, Radu, MD, Qayyum, A, Pedersen, F, Helqvist, S, Saunamäki, K, Kelbæk, H, Jørgensen, E, Engstrøm, T & Holmvang, L 2014, 'Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response: the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial', Platelets, bind 25, nr. 7, s. 506-512. https://doi.org/10.3109/09537104.2013.845874

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title = "Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response: the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial",

abstract = "High on-treatment platelet reactivity (HTPR) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). The antiplatelet effect and safety of prasugrel was compared to that of double-dose clopidogrel in patients with stable coronary artery disease or acute coronary syndrome (ACS) exhibiting HTPR on clopidogrel and treated with PCI, using multiple electrode aggregometry (MEA) to assess platelet reactivity. Of 923 patients screened, 237 (25.7%) exhibited HTPR. Of these, 106 were eligible for participation in a randomized trial comparing two intensified antiplatelet regimen: 52 were assigned to double maintenance-dose clopidogrel and 54 to standard-dose prasugrel. At 1 month, tailoring antiplatelet therapy improved platelet inhibition to a level considered as therapeutic in 73.1% of patients. Prasugrel entailed greater platelet inhibition (p = 0.02) and a lower rate of persisting HTPR at follow-up compared to double-dose clopidogrel (HTPR persisted in 20.4% and 42% respectively, p = 0.02). Within the 30-day follow-up, no major bleeds were observed and the incidence of major adverse cardiovascular events (MACE) was similar in the two treatment arms. Prasugrel demonstrated superiority to double-dose clopidogrel in overcoming HTPR and reducing platelet activity. Intensifying antiplatelet therapy in both ACS and stable angina pectoris (SAP) patients exhibiting HTPR prior to PCI was well tolerated.",

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T1 - Prasugrel or double-dose clopidogrel to overcome clopidogrel low-response

T2 - the TAILOR (Thrombocytes And IndividuaLization of ORal antiplatelet therapy in percutaneous coronary intervention) randomized trial

AU - Dridi, Nadia Paarup

AU - Johansson, Pär Ingemar

AU - Clemmensen, Peter

AU - Stissing, Trine

AU - Radu, Maria Dumitrela

AU - Qayyum, Abbas

AU - Pedersen, Frants

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Kelbæk, Henning

AU - Jørgensen, Erik

AU - Engstrøm, Thomas

AU - Holmvang, Lene

PY - 2014/11/1

Y1 - 2014/11/1

N2 - High on-treatment platelet reactivity (HTPR) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). The antiplatelet effect and safety of prasugrel was compared to that of double-dose clopidogrel in patients with stable coronary artery disease or acute coronary syndrome (ACS) exhibiting HTPR on clopidogrel and treated with PCI, using multiple electrode aggregometry (MEA) to assess platelet reactivity. Of 923 patients screened, 237 (25.7%) exhibited HTPR. Of these, 106 were eligible for participation in a randomized trial comparing two intensified antiplatelet regimen: 52 were assigned to double maintenance-dose clopidogrel and 54 to standard-dose prasugrel. At 1 month, tailoring antiplatelet therapy improved platelet inhibition to a level considered as therapeutic in 73.1% of patients. Prasugrel entailed greater platelet inhibition (p = 0.02) and a lower rate of persisting HTPR at follow-up compared to double-dose clopidogrel (HTPR persisted in 20.4% and 42% respectively, p = 0.02). Within the 30-day follow-up, no major bleeds were observed and the incidence of major adverse cardiovascular events (MACE) was similar in the two treatment arms. Prasugrel demonstrated superiority to double-dose clopidogrel in overcoming HTPR and reducing platelet activity. Intensifying antiplatelet therapy in both ACS and stable angina pectoris (SAP) patients exhibiting HTPR prior to PCI was well tolerated.

AB - High on-treatment platelet reactivity (HTPR) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). The antiplatelet effect and safety of prasugrel was compared to that of double-dose clopidogrel in patients with stable coronary artery disease or acute coronary syndrome (ACS) exhibiting HTPR on clopidogrel and treated with PCI, using multiple electrode aggregometry (MEA) to assess platelet reactivity. Of 923 patients screened, 237 (25.7%) exhibited HTPR. Of these, 106 were eligible for participation in a randomized trial comparing two intensified antiplatelet regimen: 52 were assigned to double maintenance-dose clopidogrel and 54 to standard-dose prasugrel. At 1 month, tailoring antiplatelet therapy improved platelet inhibition to a level considered as therapeutic in 73.1% of patients. Prasugrel entailed greater platelet inhibition (p = 0.02) and a lower rate of persisting HTPR at follow-up compared to double-dose clopidogrel (HTPR persisted in 20.4% and 42% respectively, p = 0.02). Within the 30-day follow-up, no major bleeds were observed and the incidence of major adverse cardiovascular events (MACE) was similar in the two treatment arms. Prasugrel demonstrated superiority to double-dose clopidogrel in overcoming HTPR and reducing platelet activity. Intensifying antiplatelet therapy in both ACS and stable angina pectoris (SAP) patients exhibiting HTPR prior to PCI was well tolerated.

U2 - 10.3109/09537104.2013.845874

DO - 10.3109/09537104.2013.845874

M3 - Journal article

C2 - 24245960

SN - 0953-7104

VL - 25

SP - 506

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JO - Platelets

JF - Platelets

IS - 7

ER -