Patients undergoing percutaneous coronary intervention with a residual high platelet reactivity despite oral clopidogrel are at increased risk of ischaemic complications. The strategies to overcome the issue consist of switch to a more potent antiplatelet medications including prasugrel or ticagrelor. Economic constrains of many countries still do not allow wide reimbursement of newer antiplatelet agents. Therefore a strategy to personalise treatment according to genotype and phenotype characteristics of the patient may provide an attractive solution combining high clinical efficacy with low budget impact.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
150
Patients harboring CYP2C19 \*2 alleles receive 60 mg prasugrel for PCI, while non-carriers receive 600 mg clopidogrel if not pretreated with clopidogrel.
Patients having high on-treatment platelet reactivity (HPR: greater than 208 PRU) receive 60 mg prasugrel loading dose (LD), others continue clopidogrel for PCI.
Heart Center Balatonfüred
Balatonfüred, Hungary
ACTIVE_NOT_RECRUITING1st Department of Cardiology, Medical University of Warsaw
Warsaw, Poland
RECRUITINGPrevalence of periprocedural myocardial injury within 24 h after PCI
Post-procedural troponin value increase exceeding the 99th percentile upper reference limit (URL) within 24 hours after PCI
Time frame: Within 24 hours after Percutaneous Coronary Intervention (PCI)
Proportion of patients having periprocedural myocardial infarction (MI)
Periprocedural MI is defined as a CK-MB elevation greater than 3x of the upper limit of norm (ULN) within 24 hours of elective PCI.
Time frame: Within 24 hours or PCI
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