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Updated: May 11, 2026

Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Factors affecting residual platelet aggregation in prasugrel treated patients
Dimitrios Alexopoulos1, Ioanna Xanthopoulou, Angelos Perperis
1Cardiology Department, Patras University Hospital, Rion 26500, Greece. dalex@med.upatras.gr
Understanding platelet reactivity (PR) to prasugrel is key for patient outcomes. High pre-treatment PR predicts high on-treatment PR, while low pre-treatment PR and loading dose predict high platelet inhibition with prasugrel.
Area of Science:
- Pharmacology
- Cardiology
- Clinical Trials
Background:
- Platelet reactivity (PR) influences outcomes in patients on antiplatelet therapy.
- Prasugrel is a P2Y12 inhibitor used to prevent thrombotic events.
- Identifying factors affecting PR to prasugrel can optimize treatment and reduce complications.
Purpose of the Study:
- To identify independent factors influencing platelet reactivity (PR) and rates of high PR (HPR) or high platelet inhibition (HPI) in patients on maintenance prasugrel.
- To determine the predictive value of pre-prasugrel PR and other clinical factors on on-treatment PR.
Main Methods:
- Retrospective analysis of 233 patients receiving prasugrel maintenance dose (MD).
- Platelet function assessed using Verify Now P2Y12 assay pre- and post-prasugrel MD.
- Multiple linear and logistic regression models used to identify independent predictors.
Main Results:
- Pre-prasugrel PR, acute coronary syndrome (ACS), prasugrel loading, and smoking explained 25.9% of PR variance under prasugrel MD.
- High pre-prasugrel PR (>313 PRU) was the sole independent predictor of HPR.
- Low pre-prasugrel PR (<242 PRU) and prasugrel loading predicted HPI.
Conclusions:
- Pre-treatment PR level significantly impacts on-treatment platelet reactivity to prasugrel.
- High pre-treatment PR is associated with high on-treatment PR (HPR).
- Low pre-treatment PR and prasugrel loading dose predict high platelet inhibition (HPI).
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