P2Y12 Receptor Inhibitors in ACS Management with or without ST-segment Elevation

2021 ◽  
Vol 10 (3) ◽  
pp. 137-140
Author(s):  
Abdulrahman Mousa Aljohani ◽  
Moaath Saleh Aljuhani ◽  
Khalid Dhaifallah Almalki ◽  
Ghassan Abdullah Alhazmi ◽  
Anas Mohammed Ghaith ◽  
...  
Keyword(s):  
P2y12 Receptor ◽  
St Segment Elevation ◽  
St Segment

P2Y12 receptor inhibition and effect of morphine in patients undergoing primary PCI for ST-segment elevation myocardial infarction

2016 ◽  
Vol 116 (08) ◽  
pp. 369-378 ◽  
Author(s):  
Johanne Silvain ◽  
Robert F. Storey ◽  
Guillaume Cayla ◽  
Jean-Baptiste Esteve ◽  
Jean-Guillaume Dillinger ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Reactivity ◽  
Platelet Inhibition ◽  
P2y12 Receptor ◽  
St Segment Elevation ◽  
Delayed Onset ◽  
Segment Elevation Myocardial Infarction ◽  
Receptor Inhibition ◽  
Morphine Administration ◽  
St Segment

SummaryPRIVATE-ATLANTIC (P2Y12 Receptor Inhibition with VASP Testing using Elisa kit during the ATLANTIC study) is a pre-specified substudy of the randomised, double-blind ATLANTIC trial in patients with ST-segment elevation myocardial infarction, designed to help interpret the main trial results. The primary objective of ATLANTIC was to assess coronary reperfusion prior to percutaneous coronary intervention (PCI) with pre- vs in-hospital ticagrelor 180 mg loading dose (LD). PRIVATE-ATLANTIC assessed platelet inhibition in 37 patients by measurement of vasodilator-associated stimulated phosphoprotein (VASP) platelet reactivity index (PRI) and VerifyNow platelet reactivity units (PRU) before angiogram (T1), immediately after PCI (T2), 1 (T3), and 6 (T4) hours (h) after PCI, and before next study drug administration (T5). The median time difference between the two ticagrelor LD was 41 minutes. Platelet reactivity was unaffected at T1 when measured by VASP-PRI (89.8 vs 93.9% for pre- and in-hospital ticagrelor, respectively; p = 0.18) or PRU (239 vs 241; p = 0.82). Numerical differences were apparent at T2 and maximal at T3. Morphine administration significantly delayed onset of platelet inhibition at T3 (VASP-PRI 78.2 vs 23.4% without morphine; p = 0.0116) and T4 (33.1 vs 11.0%; p = 0.0057). In conclusion, platelet inhibition in ATLANTIC was unaffected by pre-hospital ticagrelor administration at the time of initial angiogram due to the short transfer delay. The maximum difference in platelet inhibition was detected 1 h after PCI (T3). Morphine administration was associated with delayed onset of action of ticagrelor and appeared more important than timing of ticagrelor administration.

scholarly journals Real-world comparison of clopidogrel, prasugrel and ticagrelor in patients undergoing primary percutaneous coronary intervention

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000951 ◽  
Author(s):  
Arvindra Krishnamurthy ◽  
Claire Keeble ◽  
Michelle Anderson ◽  
Kathryn Somers ◽  
Natalie Burton-Wood ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Real World ◽  
Coronary Intervention ◽  
Outcome Data ◽  
P2y12 Receptor ◽  
St Segment Elevation ◽  
Clinical Endpoints ◽  
St Segment ◽  
Percutaneous Coronary

BackgroundThere is a paucity of real-world outcome data comparing clopidogrel, prasugrel and ticagrelor in primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI). We sought to assess the association of choice of oral P2Y12-receptor inhibitor with clinical outcomes following PPCI for STEMI in a large consecutive patient series.MethodsDemographic, procedural and 12-month outcome data were prospectively collected for all patients undergoing PPCI in Leeds, UK, between 01 January 2009 and 31 December 2011, and 01 January 2013 and 31 December 2013. Clinical endpoints were 30-day and 12-month all-cause mortality, recurrent MI and 30-day HORIZONS-major bleeding. Logistic regression analyses were undertaken to adjust for confounding factors.ResultsPrasugrel (n=1244) was associated with lower adjusted 30-day (OR 0.53 (0.34–0.85)) and 12-month (OR 0.55 (0.38–0.78)) mortality, and 12-month MI (OR 0.63 (0.42–0.94)) compared with clopidogrel (n=1648). Importantly, prasugrel was associated with lower adjusted 30-day mortality (OR 0.51 (0.29–0.91)) compared with ticagrelor (n=811). Lower 30-day (OR 0.40 (0.17–0.94)) and 12-month (OR 0.54 (0.32–0.93)) MI were observed in ticagrelor compared with clopidogrel, an association absent in comparison with prasugrel. Adjusted bleeding were not statistically significantly different among the P2Y12-receptor inhibitors.ConclusionIn this large consecutive real-world series, prasugrel was associated with lower adjusted 30-day mortality compared with ticagrelor and clopidogrel, and lower adjusted 12-month mortality compared with clopidogrel. Both prasugrel and ticagrelor were associated with lower recurrent MI following PPCI compared with clopidogrel, with no overall increase in adjusted bleeding.

scholarly journals Efficacy and safety of individualized P2Y12 receptor antagonists treatment in patients after acute myocardial infarction with ST-segment elevation

2018 ◽  
Vol 13 (11-12) ◽  
pp. 441-441
Author(s):  
Hrvoje Jurin ◽  
Jure Samardžić ◽  
Saša Pavasović ◽  
Mia Dubravčić ◽  
Marijan Pašalić ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
P2y12 Receptor ◽  
Efficacy And Safety ◽  
Receptor Antagonists ◽  
St Segment Elevation ◽  
St Segment
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