title: Inter-patient variability of platelet reactivity in patients treated with prasugrel and ticagrelor.
abstract: The aim of this study was to evaluate the distribution of platelet reactivity values in patients treated with prasugrel and ticagrelor. This prospective observational study enrolled 200 patients treated with prasugrel or ticagrelor. Platelet aggregation was determined by multiple electrode aggregometry after stimulation with adenosine diphosphate (ADP) in the maintenance phase of treatment with prasugrel or ticagrelor. Only 3% of patients in the prasugrel group and 2% of study participants in the ticagrelor group had high on treatment platelet reactivity (HTPR). The majority of patients displayed low on treatment platelet reactivity (LTPR; prasugrel: 69%; ticagrelor: 64%). The pharmacodynamic effect was similar in patients treated with prasugrel and ticagrelor: the median level of ADP-induced platelet aggregation was 15U (interquartile range IQR 9-21U) under prasugrel treatment and 17U (IQR 8-24U) under ticagrelor treatment (p=0.370). In conclusion, our study suggests that there is some degree of variability in ADP-induced platelet aggregation under treatment with prasugrel and ticagrelor.
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Jolanta M
authors.initials: JM
authors.lastname: Siller-Matula
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Betül
authors.initials: B
authors.lastname: Akca
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Neunteufl
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Lang
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kreiner
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Berger
authors.affiliation: a Department of Cardiology , Medical University of Vienna , Vienna , Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Delle-Karth
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy; D000241:Adenosine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000244:Adenosine Diphosphate / Q000494:pharmacology; D000368:Aged; D015415:Biomarkers; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000068799:Prasugrel Hydrochloride / Q000494:pharmacology* / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D000077486:Ticagrelor; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D000244:Adenosine Diphosphate; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine
keywords: Platelet aggregation; prasugrel; therapeutic window; ticagrelor; variability