A Comparative Pharmacodynamic Study of Ticagrelor versus Clopidogrel and Ticagrelor in Patients undergoing Primary Percutaneous Coronary Intervention: The CAPITAL RELOAD Study.

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dc.contributor.authorHibbert, Benjamin
dc.contributor.authorMaze, Ronnen
dc.contributor.authorPourdjabbar, Ali
dc.contributor.authorSimard, Trevor
dc.contributor.authorRamirez, F. Daniel
dc.contributor.authorMoudgil, Rohit
dc.contributor.authorBlondeau, Melissa
dc.contributor.authorLabinaz, Marino
dc.contributor.authorDick, Alexander
dc.contributor.authorGlover, Christopher
dc.contributor.authorFroeschl, Michael
dc.contributor.authorMarquis, Jean-Francois
dc.contributor.authorSo, Derek
dc.contributor.authorLe May, Michel
dc.date.accessioned2014-03-25T14:07:06Z
dc.date.available2014-03-25T14:07:06Z
dc.date.created2014
dc.date.issued2014-03-25
dc.identifier.citationHibbert B, Maze R, Pourdjabbar A, Simard T, Ramirez D, et al. (2014) A Comparative Pharmacodynamic Study of Ticagrelor versus Clopidogrel and Ticagrelor in Patients Undergoing Primary Percutaneous Coronary Intervention: the CAPITAL RELOAD Study. PLoS ONE 9(3): e92078.
dc.identifier.urihttp://hdl.handle.net/10393/30704
dc.description.abstractAbstract Background: In patients undergoing primary percutaneous coronary intervention (PPCI) ticagrelor is superior to clopidogrel in reducing cardiovascular events. This study sought to evaluate the effect of clopidogrel pretreatment on the pharmacodynamics of ticagrelor in patients undergoing PPCI. Methods: We measured platelet reactivity using the VerifyNow P2Y12 assay at baseline, 1, 2, 4, 6, 12, 24, and 48 hours following ticagrelor bolus in patients previously loaded with clopidogrel (C+T) and in thienopyridine-naive patients (T) referred to our centre for PPCI. Results: In total, 52 consecutive eligible patients with ST-elevation myocardial infarction (STEMI) were enrolled (27 C+T and 25 T). Baseline characteristics and mean baseline platelet reactivity units (PRUs) were similar between the groups. The primary endpoint, the proportion of patients achieving a PRU<208 at 2 hours, was more frequently achieved in the C+T group compared to T treatment (76.0% vs 44.4%, p=0.026). Notably, C+T therapy resulted in fewer patients with high platelet reactivity at 1 hour (56.0% vs. 14.8%), 4 hours (100.0% vs. 61.5%) and 6 hours (100.0% vs. 64%, p<0.01 for all comparisons). Furthermore, C+T therapy was associated with lower PRU values from 2 to 48 hours. Conclusions: In patients referred for PPCI, ticagrelor bolus following clopidogrel resulted in more rapid and profound platelet inhibition, demonstrating a positive pharmacodynamic interaction. Further study is needed to determine if this pharmacodynamic effect translates into reduced clinical events.
dc.description.sponsorshipNone.
dc.language.isoen
dc.subjectTicagrelor
dc.subjectSTEMI
dc.subjectPharmacodynamic
dc.titleA Comparative Pharmacodynamic Study of Ticagrelor versus Clopidogrel and Ticagrelor in Patients undergoing Primary Percutaneous Coronary Intervention: The CAPITAL RELOAD Study.
dc.typeArticle
dc.identifier.doi10.1371/journal.pone.0092078
CollectionM├ędecine // Medicine

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