scholarly journals Platelet reactivity in response to loading dose of atorvastatin or rosuvastatin in patients with stable coronary disease before percutaneous coronary intervention: The STATIPLAT randomized study

2017 ◽  
Vol 40 (8) ◽  
pp. 605-611 ◽  
Author(s):  
Cosmo Godino ◽  
Anna Giulia Pavon ◽  
Antonio Mangieri ◽  
Anna Salerno ◽  
Michela Cera ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Disease ◽  
Platelet Reactivity ◽  
Randomized Study ◽  
Coronary Intervention ◽  
Loading Dose ◽  
Percutaneous Coronary

A Comparison of INNOVANCE® PFA P2Y and VerifyNow P2Y12 Assay for the Assessment of Clopidogrel Resistance in Patients Undergoing Percutaneous Coronary Intervention

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4671-4671
Author(s):  
Soyoung Shin ◽  
Yonggoo Kim ◽  
Jihyang Lim ◽  
Jiyoung Jang ◽  
Jayoung Kim
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Conflicts Of Interest ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Loading Dose ◽  
Clinical Correlation ◽  
Clopidogrel Resistance ◽  
Correlation Studies ◽  
Percutaneous Coronary

Abstract Abstract 4671 Introduction: VerifyNow P2Y12 is commonly used to measure responsiveness to clopidogrel. We sought to compare the results obtained from novel INNOVANCE® PFA P2Y and VerifyNow P2Y12 assay for the assessment of clopidogrel resistance in patients with undergoing percutaneous coronary intervention. Methods: 255 patients undergoing percutaneous coronary intervention, preliminarily treated with 100 mg/day of aspirin followed co- administration of clopidogrel(loading dose 600 mg, maintenance dose 75 mg/day), were enrolled in this study. Platelet aggregation was measured by INNOVANCE® PFA P2Y and VerifyNow P2Y12. Results: INNOVANCE® PFA P2Y and VerifyNow P2Y12 assay showed moderate correlations with INNOVANCE® PFA P2Y Vs VerifyNow %inhibition: r = 0.412, p < 0.0001; INNOVANCE® PFA P2Y Vs VerifyNow platelet reactivity units(PRU): r = −0.402, p < 0.0001. The agreement between INNOVANCE® PFA P2Y and VerifyNow %inhibition was 85 % and that of INNOVANCE® PFA P2Y and VerifyNow platelet reactivity units(PRU) was 79%: The k statistics between INNOVANCE® PFA P2Y and VerifyNow %inhibition and platelet reactivity units(PRU) were 0.52 and 0.44, respectively. Conclusions: INNOVANCE® PFA P2Y’s sensitivity in detecting clopidogrel resistance is comparable to VerifyNow P2Y12 assay. As the PFA-100® system was already widely used, the new test cartilage may be useful tool for the assessment of clopidogrel effects. Additional Clinical correlation studies were required to validate the effectiveness of INNOVANCE® PFA P2Y for predicting long term clinical outcomes. Disclosures: No relevant conflicts of interest to declare.

How Long Does It Take for Clopidogrel and Ticagrelor to Inhibit Platelets in Patients Undergoing Primary Percutaneous Coronary Intervention? A Detailed Pharmacodynamic Analysis: Time Course of Platelet Reactivity in STEMI (TOPS)

2017 ◽  
Vol 43 (04) ◽  
pp. 439-446 ◽  
Author(s):  
Thomas Bergmeijer ◽  
Thea Godschalk ◽  
Paul Janssen ◽  
Kim Berge ◽  
Nicoline Breet ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Stent Thrombosis ◽  
Primary Percutaneous Coronary Intervention ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Platelet Inhibition ◽  
Light Transmittance ◽  
Loading Dose ◽  
Percutaneous Coronary

AbstractAntiplatelet therapy plays a pivotal role in patients with an ST-segment elevation myocardial infarction (STEMI) to prevent further atherothrombotic events, such as stent thrombosis. Although the risk of stent thrombosis is highest in the first hours after primary percutaneous coronary intervention (pPCI), little is known about when an adequate level of platelet inhibition is achieved following a clopidogrel or ticagrelor loading dose in STEMI patients. Patients presenting with STEMI in whom pPCI was performed and who were loaded with 600 mg clopidogrel or 180 mg ticagrelor were eligible for enrolment in this nonrandomized, open label, single-center study. Platelet reactivity was measured before PCI, 6 and 24 hours after loading dose and after 2, 7, and 14 days, using the VerifyNow P2Y12 assay as well as 20 µmol/L adenosine diphosphate stimulated light transmittance aggregometry (LTA). We analyzed the time until a VerifyNow result of < 236 P2Y12 reaction units or LTA maximum platelet aggregation of < 64.5% was reached. A total of 28 patients were participated in this study. Platelet reactivity dropped below the high platelet reactivity cutoff level after 11.4 (VerifyNow) and 5.7 (LTA) hours in patients who were loaded with clopidogrel, and after 2.4 (VerifyNow) and 3.9 (LTA) hours in patients who were loaded with ticagrelor. Despite the administration of a clopidogrel or ticagrelor loading dose, it still takes multiple hours (2–11) to reach adequate platelet inhibition in STEMI patients. This might indicate the need for additional antiplatelet therapy in the first hours after loading in patients undergoing pPCI with stenting.

High-Dose Clopidogrel Loading in Percutaneous Coronary Intervention

2005 ◽  
Vol 39 (5) ◽  
pp. 918-922 ◽  
Author(s):  
Kristen L Longstreth ◽  
James R Wertz
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Drug Manufacturer ◽  
Platelet Inhibition ◽  
High Dose ◽  
Loading Dose ◽  
Percutaneous Coronary ◽  
Safety Studies ◽  
Risk Patients ◽  
Time Required

OBJECTIVE: To review the use of a 600-mg clopidogrel loading dose in patients undergoing percutaneous coronary intervention (PCI). DATA SOURCES: Human clinical trials and platelet studies available through PubMed (1966–March 2005), bibliographies of pertinent articles, and citations supplied by the drug manufacturer were accessed. DATA SYNTHESIS: The administration of a 600-mg loading dose of clopidogrel can decrease the time required for maximum platelet inhibition to 2 hours compared with ⩾6 hours achieved with 300 mg. This higher loading dose has been investigated in multiple platelet studies and one observational report. Several randomized controlled trials have used a 600-mg loading dose; however, these studies were not designed to evaluate the efficacy and safety of this loading regimen. To date, only one randomized trial has compared the 600-mg loading dose with a 300-mg loading dose. CONCLUSIONS: When compared with a conventional loading regimen of 300 mg in lower-risk patients, pretreatment with clopidogrel 600 mg was shown to be more effective in reducing periprocedural events and demonstrated similar safety. Studies are needed to clarify the use of a 600-mg loading dose in higher-risk patients, with concomitant glycoprotein IIb/IIIa receptor antagonism, or when administration is delayed until immediately before or after PCI.

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