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Updated: May 17, 2026

Microfluidics in Assessing Platelet Function
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Published on: November 8, 2024

Platelet function normalization after a prasugrel loading-dose: time-dependent effect of platelet supplementation.

M U Zafar1, C Santos-Gallego, D A Vorchheimer

  • 1Mount Sinai School of Medicine, New York, NY Eli Lilly and Company, Indianapolis, IN, USA.

Journal of Thrombosis and Haemostasis : JTH
|November 10, 2012
PubMed
Summary
This summary is machine-generated.

Platelet transfusions in acute coronary syndrome (ACS) patients on prasugrel may be less effective due to drug metabolites. Supplemented platelets showed no inhibition by prasugrel metabolites 6 hours after a loading dose.

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09:13

Turbidimetry on Human Washed Platelets: The Effect of the Pannexin1-inhibitor Brilliant Blue FCF on Collagen-induced Aggregation

Published on: April 6, 2017

Area of Science:

  • Cardiology
  • Pharmacology
  • Hematology

Background:

  • Platelet transfusions are crucial for hemostasis in acute coronary syndrome (ACS) patients.
  • Thienopyridine antiplatelet agents, like prasugrel, can impair the efficacy of platelet transfusions due to their active metabolites.
  • Understanding the duration of prasugrel's active metabolite inhibition is critical for optimizing transfusion strategies.

Purpose of the Study:

  • To determine the earliest time point after a prasugrel loading dose when added platelets are no longer affected by the drug's active metabolite.
  • To provide data that can inform transfusion timing in ACS patients treated with prasugrel.

Main Methods:

  • Healthy subjects (n=25) on aspirin received a prasugrel loading dose.
  • Platelet reactivity was assessed using Maximum Platelet Aggregation (MPA) and VerifyNow® P2Y12 assays.
  • Ex-vivo addition of platelets from untreated donors at varying concentrations (40%, 60%, 80%) was performed at 2, 6, 12, and 24 hours post-prasugrel dose.

Main Results:

  • Supplemented platelets demonstrated increased reactivity in a concentration-dependent manner across all time points.
  • Platelet reactivity significantly increased between 2 and 6 hours post-prasugrel administration.
  • Platelet reactivity remained stable between 6 and 12 hours, indicating the dissipation of the active metabolite's inhibitory effect.

Conclusions:

  • The earliest time that supplemented platelets were not inhibited by prasugrel's active metabolite was observed at 6 hours post-loading dose.
  • These findings suggest that platelet transfusions administered 6 hours or later after a prasugrel loading dose may be more effective in ACS patients.
  • This has significant clinical implications for managing ACS patients requiring transfusions during critical periods, such as surgery.