The aim of this study is to compare circadian variability of antiplatelet effect of prasugrel and ticagrelor maintenance doses during the initial days after acute myocardial infarction.
Prasugrel and ticagrelor are two oral P2Y12 receptor antagonists recommended as a part of dual antiplatelet therapy with aspirin in patients with acute myocardial infarction. Both drugs exert comparable antiplatelet effect following a loading dose. However, pharmacodynamic differences exist between these P2Y12 receptor inhibitors. Prasugrel is a prodrug that requires hepatic activation and permanently binds to platelet P2Y12 receptors, whereas ticagrelor is an active drug and blocks P2Y12 receptors reversibly. Another important difference is that prasugrel maintenance dose is administered once daily, while ticagrelor requires next dosage every 12 hours. These fundamental distinctions may affect the degree of platelet inhibition on maintenance doses during the first days after acute myocardial infarction.
Study Type
OBSERVATIONAL
Enrollment
73
Patients with myocardial infarction will receive a 60 mg prasugrel loading dose, followed by a maintenance dose of 10 mg once daily
Patients with myocardial infarction will receive a 180 mg ticagrelor loading dose, followed by a maintenance dose of 90 mg twice daily
Department of Cardiology, Dr. A. Jurasz University Hospital, Collegium Medicum, Nicolaus Copernicus University
Bydgoszcz, Kuyavian-Pomeranian Voivodeship, Poland
Department of Cardiology, Wrocław Medical University
Wroclaw, Lower Silesian Voivodeship, Poland
Circadian variability of platelet inhibition assessed with VASP
Platelet inhibition evaluated with VASP assay at 8:00, 12:00, 16:00 and 20:00
Time frame: Day 4 after acute myocardial infarction
Circadian variability of platelet inhibition assessed with Multiplate
Platelet inhibition evaluated with Multiplate at 8:00, 12:00, 16:00 and 20:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity at 8:00 assessed with VASP
Number of patients with high platelet reactivity evaluated with VASP assay at 8:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity at 12:00 assessed with VASP
Number of patients with high platelet reactivity evaluated with VASP assay at 12:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity 16:00 assessed with VASP
Number of patients with high platelet reactivity evaluated with VASP assay at 16:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity 20:00 assessed with VASP
Number of patients with high platelet reactivity evaluated with VASP assay at 20:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity 08:00 assessed with Multiplate
Number of patients with high platelet reactivity evaluated with Multiplate at 08:00
Time frame: Day 4 after acute myocardial infarction
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High platelet reactivity 12:00 assessed with Multiplate
Number of patients with high platelet reactivity evaluated with Multiplate at 12:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity 16:00 assessed with Multiplate
Number of patients with high platelet reactivity evaluated with Multiplate at 16:00
Time frame: Day 4 after acute myocardial infarction
High platelet reactivity 20:00 assessed with Multiplate
Number of patients with high platelet reactivity evaluated with Multiplate at 20:00
Time frame: Day 4 after acute myocardial infarction