Platelet inhibition with prasugrel.
Summary of "Platelet inhibition with prasugrel."
Platelet activation plays a pivotal role in the pathogenesis of coronary artery disease. The long-term benefit of dual anti-platelet therapy with clopidogrel and aspirin is well established for patients with acute coronary syndrome and for secondary prophylaxis of coronary artery disease. This review discusses latest developments in the field of the thienopyridines. Particularly, we focus on the evidence-based use of prasugrel or prasugrel versus clopidogrel in clinical practice.
Affiliation
Klinik III für Innere Medizin, Herzzentrum der Universität zu Köln.
Journal Details
This article was published in the following journal.
Name: Deutsche medizinische Wochenschrift (1946)
ISSN: 1439-4413
Pages: 1542-1546
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20665417
- DOI: http://dx.doi.org/10.1055/s-0030-1262444
Medical and Biotech [MESH] Definitions
Gray Platelet Syndrome
A rare, inherited platelet disorder characterized by a selective deficiency in the number and contents of platelet alpha-granules. It is associated with THROMBOCYTOPENIA, enlarged platelets, and prolonged bleeding time.
Antigens, Human Platelet
Human alloantigens expressed only on platelets, specifically on platelet membrane glycoproteins. These platelet-specific antigens are immunogenic and can result in pathological reactions to transfusion therapy.
Aspirin
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
Platelet Membrane Glycoprotein Iib
Platelet membrane glycoprotein IIb is an integrin alpha subunit that heterodimerizes with INTEGRIN BETA3 to form PLATELET GLYCOPROTEIN GPIIB-IIIA COMPLEX. It is synthesized as a single polypeptide chain which is then postranslationally cleaved and processed into two disulfide-linked subunits of approximately 18 and 110 kDa in size.
Anti-inflammatory Agents, Non-steroidal
Anti-inflammatory agents that are not steroids. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions. They are used primarily in the treatment of chronic arthritic conditions and certain soft tissue disorders associated with pain and inflammation. They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects. Certain NSAIDs also may inhibit lipoxygenase enzymes or TYPE C PHOSPHOLIPASES or may modulate T-cell function. (AMA Drug Evaluations Annual, 1994, p 1814-5)
PubMed Articles
Although there is considerable variability of platelet reactivity among patients treated with clopidogrel, little is known about inter-individual differences and possible role of proton pump inhibitor...
OBJECTIVES: The objective was to evaluate the pharmacodynamic response of switching patients on maintenance phase clopidogrel therapy after an acute coronary syndrome (ACS) to prasugrel. BACKGROUND: P...
Prasugrel, through its active metabolite, reduces atherothrombosis and its clinical manifestations by inhibiting platelet activation and aggregation. Platelets also contribute to inflammation through...
The aim of this study was to confirm prior modeling data suggesting that prasugrel 5 mg in low-body-weight (LBW) patients would be noninferior to prasugrel 10 mg in higher-body-weight (HBW) patients a...
Background: High on clopidogrel treatment platelet reactivity (HTPR) is frequent in patients on hemodialysis (HD). Objectives: The primary aim of the study was to determine the antiplatelet effect...
Clinical Trials
A Study of Acute Coronary Syndrome Patients
This study will evaluate the use of a prasugrel 60 mg loading dose administered during percutaneous coronary intervention (PCI) with and without a prior loading dose (LD)of clopidogrel on...
Plavix, Prasugrel and Drug Eluting Stents Pilot Trial
- The purpose of this study is to determine the level of inhibition of platelet activation of an approved thienopyridine(clopidogrel or prasugrel) and aspirin regimen in the...
Platelet Inhibition in Patients With Systolic Heart Failure
The investigators aim to determine if patients with systolic heart failure treated with prasugrel achieve greater platelet inhibition compared to those treated with clopidogrel.
Background: Both prasugrel and clopidogrel are prescribed drugs which compete as platelet inhibitors in patients with acute coronary syndrome (ACS). Whether rates of drug resistance/hypore...
Prasugrel/Clopidogrel Maintenance Dose Washout Study
The primary objective of the study is to describe the cumulative proportion of subjects who return to baseline platelet P2Y12 receptor function over time (up to 12 days post last maintenan...
