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Comparison of prasugrel and clopidogrel reloading on high platelet reactivity in clopidogrel-loaded patients

Dong-Hyun Lee1, Moo Hyun Kim, Tae-Ho Park

  • 1Department of Cardiology, Dong-A University Hospital, 3-1, Dongdaeshin-Dong, Seo-Gu, Busan 602-715, Republic of Korea.

Trials
|March 2, 2013
PubMed

Insights

This study compared prasugrel and clopidogrel reloading in patients with high on-treatment platelet reactivity (HPR) after initial clopidogrel loading. Prasugrel reloading demonstrated greater effectiveness in reducing HPR post-percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Reduced responsiveness to clopidogrel is linked to increased cardiovascular events.
  • High on-treatment platelet reactivity (HPR) necessitates effective antiplatelet strategies.
  • Prasugrel offers a more consistent and rapid antiplatelet effect than clopidogrel.

Purpose of the Study:

  • To compare the efficacy of prasugrel versus clopidogrel reloading in patients with HPR.
  • To evaluate the effectiveness of prasugrel in suppressing residual platelet reactivity.
  • To assess the safety and clinical outcomes of both reloading strategies.

Main Methods:

  • Prospective, randomized, open-label, active-controlled study (PRAISE-HPR trial).
  • 76 patients undergoing percutaneous coronary intervention (PCI) with HPR after clopidogrel loading.
  • Random assignment to prasugrel (20 mg) or clopidogrel (300 mg) reloading.

Main Results:

  • Primary endpoint: HPR at 24 hours post-PCI, measured by VerifyNow assay.
  • Secondary endpoints: sustained HPR rates and 30-day clinical outcomes.
  • The study aimed to determine which reloading agent is superior for HPR reduction.

Conclusions:

  • PRAISE-HPR is a randomized controlled trial investigating prasugrel and clopidogrel reloading for residual HPR.
  • The trial assesses the efficacy and safety of these antiplatelet strategies.
  • Results were planned for public release in 2013.
Abstract

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