title: Randomized comparison of new dual-antiplatelet therapy (aspirin, prasugrel) and triple-antiplatelet therapy (aspirin, clopidogrel, cilostazol) using P2Y12 point-of-care assay in patients with STEMI undergoing primary PCI.
abstract: BACKGROUND
  Both new dual antiplatelet therapy (DAT; aspirin and prasugrel) and triple antiplatelet therapy (TAT; aspirin, clopidogrel and cilostazol) are more potent than classic DAT (aspirin and clopidogrel). We compared the antiplatelet efficacy between new DAT and TAT in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary coronary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Forty patients who were eligible for primary PCI were prospectively randomized to DAT group (n=20) or TAT group (n=20) immediately after hospital arrival. The primary end point was P2Y12 reaction unit (PRU) determined with the VerifyNow P2Y12 point-of-care assay at the time of discharge.
  
  
  RESULTS
  PRU value at discharge was significantly lower in patients receiving DAT compared with that of TAT (84.5 ± 44.7 vs. 128.4 ± 74.9, p=0.032). Percent platelet inhibition was significantly higher for DAT compared with TAT at discharge (72.1 ± 12.2 vs. 57.5 ± 23.5, p=0.020). Inter-patient variability of PRU values at discharge was significantly smaller in patient taking DAT compared with TAT (p=0.026).
  
  
  CONCLUSIONS
  A new DAT is more potent antiplatelet therapy than TAT in patients with STEMI undergoing primary PCI.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Cardiovascular Research Institute, Busan Paik Hospital, Busan, South Korea. yangthmd@naver.com
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yang
authors.forename: Han-Young
authors.initials: HY
authors.lastname: Jin
authors.forename: Kyu-Nam
authors.initials: KN
authors.lastname: Choi
authors.forename: Ungjeong
authors.initials: U
authors.lastname: Do
authors.forename: Hyung Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sang-Ryul
authors.initials: SR
authors.lastname: Chung
authors.forename: Jeong-Sook
authors.initials: JS
authors.lastname: Seo
authors.forename: Jae-Sik
authors.initials: JS
authors.lastname: Jang
authors.forename: Dae-Kyeong
authors.initials: DK
authors.lastname: Kim
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D000077407:Cilostazol; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010879:Piperazines / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D019095:Point-of-Care Systems; D000068799:Prasugrel Hydrochloride; D011446:Prospective Studies; D058925:Receptors, Purinergic P2Y12 / Q000097:blood; D013777:Tetrazoles / Q000008:administration & dosage*; D013876:Thiophenes / Q000008:administration & dosage*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: C548576:P2RY12 protein, human; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058925:Receptors, Purinergic P2Y12; D013777:Tetrazoles; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin
keywords: Cilostazol; Clopidogrel; Point-of-care systems; Prasugrel