Related Experiment Video
Updated: Apr 12, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Comparison of Prasugrel and Ticagrelor Antiplatelet Effects in Korean Patients Presenting With ST-Segment Elevation
Insights
Prasugrel and ticagrelor effectively reduced platelet reactivity in Korean ST-segment elevation myocardial infarction patients. Most patients achieved low platelet reactivity, indicating good drug efficacy for these P2Y12 inhibitors.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Limited data exists on prasugrel and ticagrelor efficacy in Korean patients with ST-segment elevation myocardial infarction (STEMI).
- Assessing antiplatelet therapy effectiveness is crucial for managing STEMI patients undergoing percutaneous coronary intervention.
Purpose of the Study:
- To compare the efficacy of prasugrel and ticagrelor in inhibiting platelet reactivity in Korean STEMI patients.
- To evaluate the proportion of patients achieving low platelet reactivity with these P2Y12 inhibitors.
Main Methods:
- A double-blind, prospective pilot study randomized 39 STEMI patients undergoing primary percutaneous coronary intervention.
- Patients received either prasugrel (loading dose 60 mg, maintenance 10 mg daily) or ticagrelor (loading dose 180 mg, maintenance 90 mg twice daily).
- Platelet reactivity was assessed using VerifyNow and Vasodilator-Stimulated Phosphoprotein (VASP) P2Y12 assays at 48 hours post-loading dose.
Main Results:
- Both prasugrel and ticagrelor significantly reduced platelet reactivity compared to baseline.
- Similar and significantly lower P2Y12 reaction units (PRU) and platelet reactivity indexes (PRI) were observed in both groups at 48 hours.
- A high proportion of patients achieved low platelet reactivity: 95% had PRU values <85 and 82% had PRI <16%.
Conclusions:
- Prasugrel and ticagrelor demonstrated effectiveness in platelet inhibition among Korean STEMI patients.
- Nearly all patients exhibited low platelet reactivity at 48 hours after the loading dose.
- The high rate of very low platelet reactivity warrants further investigation into the safety profile of these drugs in this population.
Background:
There is insufficient data on the efficacy of prasugrel and ticagrelor in Korean patients with ST-segment elevation myocardial infarction (STEMI).
Methods And Results:
I n the current double-blind, prospective pilot study, 39 patients with STEMI undergoing primary percutaneous coronary intervention were randomized to receive prasugrel 60 mg loading dose (LD) followed by 10 mg daily maintenance dose (n=19), or ticagrelor 180 mg LD followed by 90 mg twice daily maintenance dose (n=20). We assessed platelet reactivity with the VerifyNow and Vasodilator-Stimulated Phosphoprotein (VASP) P2Y12 assays. Compared to baseline platelet reactivity, both prasugrel and ticagrelor groups achieved similar and significantly lower P2Y12 reaction units (PRU) (259 [IQR: 230 to 281] vs. 28 [12 to 55] for prasugrel; 261 [196 to 286] vs. 43 [11 to 61] for ticagrelor), and platelet reactivity indexes (PRI) (51.2% [39.3 to 61.3] vs. 8.1% [6.1 to 14.7] for prasugrel; 47.5% [38.4 to 50.4] vs. 11.2% [7.1 to 15.5] for ticagrelor, all P values <0.001) at 48 h post-LD. Most patients had low platelet reactivity with 95% PRU values <85 and 82% with PRI <16%.
Conclusions:
Both prasugrel and ticagrelor were effective for platelet inhibition in Korean STEMI patients with almost no patients exhibiting high platelet reactivity at 48 h after the LD. Our finding of a high number of patients with very low platelet reactivity deserves further studies to assess the safety of the drugs (Prasugrel and Ticagrelor in ST-segment Elevation Myocardial Infarction Study, NCT02075125).
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...