Abstract 17577: Searching for the Optimal Regimen of Potent P2Y12 Inhibitor in East Asian Patients with Acute Coronary Syndrome: A Pharmacodynamic Study
Introduction: The efficacy of prasugrel and ticagrelor has not been well evaluated in East Asian. We sought to compare the pharmacodynamic efficacy of prasugrel and ticagrelor by using VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA).
Methods: From 2012 January to 2014 April, we selected 83 patients who were administered ticagrelor 90 mg twice daily (n = 24), prasugrel 10 mg daily (n = 39), or prasugrel 5 mg daily (n = 20) after percutaneous coronary intervention due to acute coronary syndrome in our institute. After 3-4 weeks, on-treatment platelet reactivity (OPR) was measured by VerifyNow assay. According to the previous studies, we used 2 different criteria for the therapeutic window of OPR (East Asian criteria: 275≥PRU>85; Western criteria: 208 ≥PRU>85). We compared the OPR and the proportion of the therapeutic window between 3 groups.
Results: The OPR was the lowest in the ticagrelor group, followed by the prasugrel 10 mg and prasugrel 5 mg groups (49.1 ± 29.9 vs. 83.7 ± 57.1 vs. 168.5 ± 60.8, p < 0.001).When we used the East Asian criteria, the prasugrel 5 mg group had the highest proportion of patients in the therapeutic window of OPR followed by prasugrel 10mg and ticagrelor groups ( 90.0% vs. 46.2% vs. 12.5%, p < 0.001). When using Western criteria, the prasugrel 5mg group still showed the highest proportion of patients with therapeutic window followed by prasugrel 10mg and ticagrelor groups (60.0% vs. 43.6% vs. 12.5%, p<0.001).
Conclusion: Short-term administration of prasugrel 5mg highly led the patients into the therapeutic window of OPR (in both of East Asian and Western criteria), compared with prasugrel 10mg and ticagrelor 180mg group. The prasugrel 5mg daily might be the optimal maintenance regimen for East Asian patients.
Author Disclosures: J. Kim: None. J. Lee: None. J. Lee: None. Y. Youn: None. M. Ahn: None. S. Ahn: None. B. Yoo: None. S. Lee: None. J. Yoon: None.
- © 2014 by American Heart Association, Inc.