title: Platelet function monitoring in elderly patients on prasugrel after stenting for an acute coronary syndrome: design of the randomized antarctic study.
abstract: BACKGROUND
  Elderly patients are at high risk for both ischemic and bleeding events. Platelet monitoring offers the opportunity to individualized antiplatelet therapy to optimize the therapeutic risk/benefit ratio.
  
  
  METHODS
  The ANTARCTIC study is designed to demonstrate the superiority of a strategy of platelet function monitoring with dose and drug adjustment in patients initially on prasugrel 5 mg as compared with a more conventional strategy using prasugrel 5 mg without monitoring and without adjustment (Conventional Treatment Arm) to reduce the primary end point evaluated 1 year after stent percutaneous coronary intervention in elderly patients presenting with an acute coronary syndrome (ACS). ANTARCTIC is a multicenter, prospective, open-label study with 2 parallel arms. A total of 852 elderly patients (≥ 75 years) undergoing stent percutaneous coronary intervention for ACS are to be enrolled. The primary end point is the time to first occurrence of cardiovascular death, myocardial infarction, stroke, definite stent thrombosis, urgent revascularization, and bleeding complications (Bleeding Academic Research Consortium definition 2, 3, or 5). Platelet function analyses will be performed 14 days after randomization and repeated 14 days later in patients who require a change in treatment.
  
  
  CONCLUSIONS
  ANTARCTIC is a nationwide, prospective, open-label study testing a strategy of platelet function monitoring with dose and drug adjustment to reduce ischemic and bleeding complications in elderly ACS patients undergoing coronary stenting.
authors.affiliation: Service de Cardiologie, CHU Carémeau, Nîmes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cayla
authors.affiliation: Departement de Cardiologie, Hôpital de la Timone, Marseille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cuisset
authors.affiliation: Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Johanne
authors.initials: J
authors.lastname: Silvain
authors.affiliation: Service de Cardiologie, Hôpital Lariboisière, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Henry
authors.affiliation: Departement de Cardiologie, CHU, Montpellier, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.affiliation: Service de Cardiologie, CHU, Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Service de Cardiologie, CHU, Tours, France.
authors.forename: Christophe Saint
authors.initials: CS
authors.lastname: Etienne
authors.affiliation: Service de Cardiologie, CH, Annecy, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Belle
authors.affiliation: Service de Cardiologie, Hôpital Louis Pasteur, Le Coudray, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Rangé
authors.affiliation: Clinique Sainte Clotilde, Saint Denis, La Réunion, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pouillot
authors.affiliation: Service de Cardiologie, Hôpital Cochin, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Varenne
authors.affiliation: Service de Cardiologie CHRU, Lille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Van Belle
authors.affiliation: Service de Cardiologie, CH, Bastia, France.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Boueri
authors.affiliation: Service de Cardiologie, CHRU, Clermont-Ferrand, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Motreff
authors.affiliation: Service de Cardiologie, CH, de Lagny, Marne-la-Vallée, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Elhadad
authors.affiliation: Hôpital François Mitterand, CH, Pau, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Delarche
authors.affiliation: Hôpital Ambroise Paré, Boulogne-Billancourt, France.
authors.forename: Rami
authors.initials: R
authors.lastname: El Mahmoud
authors.affiliation: Unité de Recherche Clinique Lariboisère, Hôpital Fernand Widal, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vicaut
authors.affiliation: Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Collet
authors.affiliation: Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France. Electronic address: gilles.montalescot@psl.aphp.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Montalescot
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods*; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D017202:Myocardial Ischemia / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention; D010879:Piperazines / Q000627:therapeutic use*; D010979:Platelet Function Tests; D000068799:Prasugrel Hydrochloride; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D015607:Stents; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010879:Piperazines; D058921:Purinergic P2Y Receptor Antagonists; D013876:Thiophenes; D000068799:Prasugrel Hydrochloride